Vicki Lachmann, from suburban Chicago, is very familiar with the “Give an Hour” program – an organization that provides free therapy to post 9/11 veterans and their families. As a therapist experienced in treating mood disorders, Post-Traumatic Stress Disorder, depression and panic disorders, among other conditions she’s treated for the past 30 years, Lachmann has seen her fair share of clients with debilitating conditions.
But she has volunteered to see clients free of charge through the “Give an Hour” program for the past three years very personal reasons.
Q: Why do you do volunteer for “Give an Hour?”
A: I graduated from high school in 1969 during the Viet Nam era. My friends were being drafted, and they were usually sent to combat during these years. I went off to college at the University of Wisconsin, often referred to as the “Berkeley of the Midwest.” My family was very liberal. I participated in demonstrations literally every night, as Madison was practically the only college that did not shut down and send all the students home during the spring of 1970. In my circle, our actions were always nonviolent (this was well before events like the bombing of the Science lab, etc., in Madison). The protests ended each evening with police and National Guardsmen, in riot gear, shooting tear gas into the crowd listening to speakers.
I tell this experience at length to explain that this was my experience – my frame of reference. I was quite simply against the war. Our country was very split along these lines: for or against.
However, I did not give enough consideration to what I now know was the horror of our veteran’s returning from that horror to Americans their own age, treating them with disdain. I never personally insulted the returning vets I encountered. Indeed, a dear friend was a member of the Special Forces (Green Beret) and was a paramedic, an awful job if there ever was one.
I simply did not give any thought to what was their nightmare, and so did not extend even one act of kindness, much less empathy. I was 20 years old and immature. No one who had not been there yet knew of the unspeakable experiences our service people endured in what I still consider that “dirty little war.” But in time I learned. As a psychotherapist, on the rare occasion these veteran’s sought treatment, I learned from the experts.
I don’t blame myself for my ignorance back then. But in time I learned what I hadn’t known. And I learned it from these Viet Nam era vets. I learned about the endlessly ongoing nightmares and unexpected rages from the Marine who said he “left his soul” in Viet Nam. When they would open up, I heard of point men who came into a clearing to find their comrade’s “head on a stick.” I am this graphic only to try to impart how very stunned I was by my lazy, safe, utter lack of caring or empathy for these service people. I just didn’t think much about it.
So, from that era to this, I felt like I wanted to do some small thing to assuage my guilt. I began to study even more than I already knew about treating trauma survivors, by attending seminars specifically for counselors who would be treating returning vets. I concluded that there could hardly be any vet who might not endure the after effects of being deployed in a conflict where there could never be safety from life-threatening danger. There is nowhere in either Afghanistan or Iraq that is not the front line. An IED or sniper can be anywhere. We psychology types believe that all it takes to possibly induce PTSD symptoms is the sure knowledge that one is in an environment where someone might be suddenly seriously injured or die.
When I learned about “Give an Hour,” by searching online for an opportunity to be of help, I signed up.
Q: How many clients a week do you see who are involved with the “Give an Hour” program?
A: It might be six or 10 including a family member or it might be one or two. It varies greatly. We know they are coming, however, as the stigma decreases, and the servicemen return, I anticipate an enormous flood of people deserving of mental health services, and I hope they’ll come. I want to be present and prepared.
Q: What is the chief complaint clients present when coming to your office?
A: Oh, I guess the initial tendency is to understandably minimize, so I’ll hear about a sleep complaint, a relational issue, just about anything that is a not-so threatening. A small piece of a bigger issue.
Q: I realize this may be hard to answer, but how long, on average, does it take for a client to get his or her PTSD under control?
A: We believe that any individual’s recovery is related to what we call “premorbid.” That is, how effective were their coping abilities before the onset of the problem? This is true for everyone, not just vets. But in general, I’d sure want to see someone having developed a good result within two to three months at most.
Q: Aside from PTSD, what other sort of problems do veterans and their families come to see you for?
A: This is a hugely important point. PTSD is a diagnosis used quite a bit as a catch-all, but it is just that – only a diagnosis. I see the whole person. This means that what I am really addressing are things like the understandable reactions to “PTSD” symptoms. Very often, this includes alcohol or drug dependency, depression, anxiety and rage to name just a few. I have always worked with patients suffering from depression and all of its accompanying issues, as there are so many people with this disorder.
Q: How can friends or families encourage a veteran to seek therapeutic help if the veteran doesn’t believe he or she needs it?
A: I always suggest that a family member keep it light, and suggest this, “Please do this just to humor me. I love you and it would make me feel like we’ve tried just about everything.” If I can get them through the door I can usually reel them in. Because I’m first about inspiring hope. Meet people where they are, and only do what works.
Q: What are some typical behaviors of a person with PTSD?
A: PTSD is known to have these recurring nightmares that are so terrifying and graphic that people simply don’t want to sleep. Thus, the use of alcohol and drugs to make oneself so numb or blacked out that the dreams are sometimes slept through. But there are also waking flashbacks. A loud noise can instantly put someone back into the fight-or-flight mode in the blink of an eye.
These flashbacks are not just an image moving through one’s mind. They can describe the screams, physical sensations and often times the exact smell of the gas, or oil, or smoke or whatever. Smell is actually known to be the most evocative of the senses. Smell conjures up and accompanies a memory most vividly. So what results is called hyper vigilance. I never walk up behind someone, and touch them without asking, or open a door without warning. This is true for survivors of war, but also survivors of sexual abuse or any violence. They’ll isolate and feel unreal or dissociated like they’re watching themselves from above.
Some (soldiers) with PTSD think they’re losing their minds. They are often not their authentic selves. If they were gentle (or of course if they weren’t) before the trauma, now they’ll often erupt in a rage so big, they themselves are terrified of what they might be capable of. They have anxiety. They feel like an alien has invaded their bodies and taken over their lives and actions. That is often something most people don’t anticipate – that living a life where every nerve ending is jangling for months on end. But it’s also the most alive they’ll ever feel. They have that, and the bond of utter commitment to their fellows, the sheer intimacy of that is something every human craves and most will never feel.
It takes too much vulnerability – too much “coming out of one’s comfort zone” emotionally, and so these folks are made to get to this level of utter aliveness, and its hard if not impossible to replicate back home. So they re-up and have many deployments. I believe it’s what they mean when they say they can’t readjust to civilian life. These feelings, even though they’re obtained through awful circumstances are addictive. Addicts can also be excitement junkies. We counselors have to help clients replicate this stuff in healthier ways. Get a Harley. Jump out of an airplane. Get vulnerable.
Q: What are the typical behaviors of a person with depression?
A: I always say that I wish we had another name for this cluster of symptoms, because many people with it don’t ever experience a depressed mood. Among these symptoms are: sleep disruption, increased irritability (stuff that doesn’t usually bother you does, like a line moving too slowly), decreased concentration (you have to read the same paragraph three times to “get it,” decreased pleasure, lack of motivation (you want to, but can’t get off the couch), change in appetite, perseverating (what I call “thoughts on a loop”), you keep worrying over something without being able to intervene on yourself. Then, of course, the more well-known symptoms, like hopelessness, thoughts of checking out (this is not usually true suicidal thinking. One just wishes he or she could go to sleep for a while. Just disappear from their problems until they feel better), a tendency to weep, even when it’s not that sad, rage, anxiety, rapid heartbeat, wanting to flee, dizziness, lightheadedness, numbness in limbs, and many others.
And we fix it by getting help and doing anything that one can think of to fix ourselves or escape, especially because our culture’s stigma continues to say that we should be able to “pull ourselves out of it.” Because this is known to be a bonafide medical condition, this stigma is the bane of my existence. We wouldn’t tell a diabetic whose blood sugar is off to suck it up and fix it!
Q: Do you sometimes recommend a combination of pharmaceutical drugs combined with talk therapy for clients?
A: Absolutely! While only an MD can prescribe, I have made it a point to learn a lot about the psychopharmacology. I worked for the psychiatrists in my metro area and I learned at the feet of the masters. I never insist, but warn people that I will gently urge considering this when indicated, which is often. There is so much misinformation about antidepressants in particular, but the truth is this: the right one (and yes sometimes we need to try one or two to find the right one) will not change your personality, hurt your organs or make you dependent. They are actually way safer than just about anything else like allergy meds, or high blood pressure meds. Once again, the stigma makes my job way tougher than it should have to be! The success rate at treating disorders like depression can usually be in the 90th percentiles with both meds and talk therapy but it drops to below 40 percent with just one or the other.
Q: How long have you been in private practice and what are your credentials?
A: Fifteen years in private practice. For the prior 15 years I worked in the private practice belonging to two psychiatrists who run the largest provider of behavioral health services in my area. I’ve been a counselor for 40 years.
My credentials include my state’s license and I’m a Licensed Clinical Professional Counselor. I’m credentialed as a Certified Alcohol and Drug Counselor, I’m also credentialed as a Compulsive Gambling Counselor, a Relapse Prevention Counselor, and I do interventions. I’m also a Certified Sexual Dysfunction Counselor, which my kids think is a hoot, of course.
For more information about the “Give an Hour” program visit giveanhour.org.
TXK Today article about Give an Hour – http://txktoday.com/featured/mental-health-professionals-give-an-hour-to-veterans/