The Struggle To Transition

For many who served in Afghanistan, the stress of combat and being in dangerous situations led to post-traumatic stress disorder (PTSD) and other non-visible wounds. But help is available, through Veterans Affairs programs, counselling services, and outside agencies such as the Veterans Transition Network. (Cpl Simon Duchesne, Combat Camera)

(Volume 24-5)

By Tyler Hooper

For Canadian Armed Forces members facing release, the reality of finding a new job, a new home, applying for benefits, adjusting to life out of uniform can present several challenges. For those dealing with mental and health issues, it can be even more daunting.

The transition to civilian life for former Canadian Army medic Sergeant Elizabeth Newman has been anything but easy. In 2010, while working with the military at the 2010 Vancouver Winter Olympics, Newman became very sick. She developed Legionnaires’ disease, acute respiratory distress syndrome (ARDS), and sepsis, a serious blood infection that is often fatal. With her heart, kidneys, and brain starting to fail, Newman’s survival looked dire. 

“I know now I probably had a 70 per cent chance of dying,” Newman told Esprit de Corps.

Ultimately, she was in a coma for almost four weeks before her body began to recover. Approximately almost a month into her recovery she was back at work, a decision that would create an entirely different battle. 

Prior to falling ill, Newman had served two tours in Afghanistan, her second and final one being in 2008. Newman deployed with the 1st Canadian Field Ambulance Unit during the Taliban resurgence. From 2006 until 2009 the Canadian military in Afghanistan would experience some of the most intense firefights in recent memory.

 Sergeant Elizabeth Newman did two tours of duty in Afghanistan as a medic with the 1st Canadian Field Ambulance Unit at the height of the heaviest fighting. But transitioning to civilian life after a
20-year career in the Canadian Armed Forces and suffering from PTSD has not been easy for her. (courtesy elizabeth newman)

“That was a really bad tour,” Newman recalled. “I made a conscious decision on the first day that this wasn’t real life.”

With her fellow soldiers suffering serious injuries and wounds — and others being killed — Newman began to compartmentalize the trauma to push on with the job. Like many soldiers do, Newman used humour to cope, while thinking, “I’m going to pay for that one later.” When Newman came back from her last tour she threw herself into work, trying to compartmentalize her experiences in Afghanistan.

“Inevitably, people throw themselves into work, they lose their relationships, they lose their families … and then it gets harder and harder to ignore the subconscious,” Newman said.

After her recovery from her coma, Newman was put in charge of a reserve course exercise near Williams Lake, B.C. However, being in such a remote region, with a lack of proper health resources, caused her undiagnosed post-traumatic stress disorder (PTSD) to manifest. “[I] started to spiral downhill really quickly,” Newman recalled.

The illness and subsequent coma Newman fell into caused brain damage, and although she cannot directly correlate the brain damage to the triggering of her trauma and PTSD, it seems likely that the brain damage played a part in her “downhill” spiral.

Not long after, her 20-year career in the military ended, something she had an incredibly hard time accepting. To make matters worse, she says her transition to the civilian world was made difficult by certain units and people in the military who, she says, did a poor job of helping her manage her retirement and transition back to civilian life.

Apart from the struggle to treat her PTSD, battling the stigma associated with PTSD, and trying to put her life together, she says that the military, particularly the treatment she received from the Joint Personnel Support Unit (JPSU) in Esquimalt, was beyond unsatisfactory. She claims they were “unhelpful” and not overly empathetic in supporting her. She even says she received the wrong retirement package from the military.

When asked about Newman’s experience with JPSU Esquimalt, CAF spokesperson Lt(N) Kelly Boyden told Esprit de Corps in an e-mail, “If a member has any concerns regarding their care and support, they are strongly encouraged to raise these concerns with their Joint Personnel Support Unit staff. Bringing their concerns forward will allow staff to address them and hopefully resolve any issues at the lowest level. Ultimately, the goal is to ensure the best possible care and support for the member.”

In a separate comment, Veteran Affairs Canada spokesperson, Marc Lescoutre, admitted in an e-mail to Esprit de Corps, that “more work needs to be done … this means harmonized services, clear guidance, timely access to benefits and services, and coordinated case management between both departments during transition.” However, Lescoutre ultimately said, “The goal [of VAC] is to help transitioning members find their new normal and to help them through this process, however long it might take, with the dignity, respect and support they so fully deserve.”

Part of the challenge for VAC and the military is that not every soldier or veteran has the same problems transitioning back to the civilian world. Oliver Thorne, who is the National Operations Director of the Veteran Transition Network (VTN), says that lifestyle and career adjustments are two of the biggest and broadest issues. VTN was founded to help veterans share their stories with fellow soldiers, and offers programs to help veterans transition back to civilian life.

Veterans gather to discuss issues facing them in a group setting. The staff and volunteers of the VTN assist vets to find balance in their new life. (vtn)

Thorne said that an integral part of the VTN program is for veterans to identify the barriers to overcoming a difficult transition, and to recognize these barriers early in their transition. Thorne added that if these barriers are not recognized early, the likely hood of a veteran developing negative coping mechanisms, such as substance abuse or isolation, becomes greater.

Currently, there’s a four-year pilot Veteran Family Program taking place at the Esquimalt Military Family Resource Centre (MFRC) based in Victoria, B.C. The Veteran Family Program provides services for medically released CAF members for a two-year period after their release. Jon Chabun, Communication and Marketing Coordinator for the MFRC, said that medically released soldiers were chosen as “that was the group that most [needed] assistance.” According to Chabun, the MFRC Veteran Family Program offers short-term services such as counselling, social work, help with finding community resources and navigating civilian health care as well as emergency services.

But for Elizabeth Newman, her transition was not only painful, she also says it stalled the progress she had made treating her brain injuries and PTSD.

“We have to have a focus on how we return citizens back to our community … we’re doing a terrible job,” Newman stated. She added that she doesn’t see it as the military’s job to help soldiers transition. Ultimately, she says that an outside organization should be a part of helping veterans transitioning, an organization, that unlike the military, is not always focused on “pushing forward.”

BRINGING RELIEF TO VETERANS

A few capsules, each containing approximately 0.1 grams of MDMA crystals, more commonly referred to as ecstasy. Although MDMA is generally illegal in most countries, researchers are investigating whether a few low doses of MDMA may assist in treating severe, treatment-resistant post-traumatic stress disorder. In November 2016, phase 3 clinical trials for PTSD were approved by the United States Food and Drug Administration to assess effectiveness and safety. (wikipedia)

(Volume 24-01)

By Tyler Hooper

 A clinical study, which saw psychotherapy used in conjunction with the drug methylenedioxymethamphetamine (MDMA) to treat psychological and emotional trauma, wrapped up in Vancouver last November, and the results appear to be hopeful.

The study was led by several Vancouver-based psychotherapists who administered MDMA to six patients suffering from post-traumatic stress disorder (PTSD) to assist with psychotherapy sessions. Several of the patients are military veterans suffering from PTSD.

According to the Canadian Mental Health Association, PTSD “often involves exposure to trauma from single events that involve death or the threat of death or serious injury.” PTSD, through certain triggers such as sound or smell, often causes those who have witnessed trauma to relive the event. Those who suffer from PTSD often suffer from flashbacks, nightmares, have trouble sleeping and may become anxious, depressed and/or detached from their surroundings.

MDMA, commonly referred to as ecstasy (E), is labelled a psychoactive drug whose effects include increased sensations of empathy, euphoria and trust. The therapists who administered the drug to the clinical trial patients hoped the drug would allow the patients to open up more about their thoughts and feelings. Ultimately, the therapist ends up having a conversation with the person’s unconscious mind, which can be quite different from a regular conversation.

According to the therapists who administered the study, the drug increases the release of chemicals like serotonin, dopamine and hormones that, in theory, can relax patients, thereby allowing them to speak more freely about their thoughts and experiences.

Metro News reported that the patients were given 125mg of MDMA with eight hours of therapy. The patients also slept at the clinic and received additional counselling the following day; months later, they were given half the dose and more therapy.

The study was funded by the Multidisciplinary Association for Psychedelic Studies (MAPS) and a good portion of the funding for the study came from online donations from the MAPS website. It took Health Canada almost six years and $200,000 to approve the trial.

Mark Haden, chair on MAPS Canada’s Board of Directors and an adjunct professor at the UBC School of Population and Public Health, said that veterans often tend to be resistant to psychotherapy or talking in a group setting. Haden added that, “When you tell them that they don’t need to talk very much … that is quite attractive to veterans.”

Haden told Esprit de Corps, “To be honest with you, I was surprised of the level of welcome we got from the Canadian military. I sort of braced myself going into the military to talk about it … I really thought I would be challenged.” Haden added that while presenting to the Canadian military there seemed to be genuine interest shown towards the study.

The two diagrams above show the results of the recent study, in terms of treatment (left) and severity of symptoms (right). Published in the Journal of Psychopharmacology, the study reveals that 83 per cent of the subjects receiving MDMA-assisted psychotherapy in a pilot study no longer met the criteria for PTSD, and every patient who received a placebo and then went on to receive MDMA-assisted psychotherapy experienced significant and lasting improvements. (mithoefer et al, 2010)

A long-term follow-up of patients in this program who received MDMA-assisted psychotherapy revealed that overall benefits were maintained an average of 3.8 years later. According to the Multidisciplinary Association for Psychedelic Studies (MAPS), these results indicate a promising future for MDMA-assisted psychotherapy for PTSD and lay the groundwork for continued research into the safest and most effective ways to administer the treatment. (mithoefer et al., 2012)

In April of 2016, a psychiatrist from the Canadian Armed Forces told Global News that the military was not ruling out these sorts of alternative treatment, but the studies would need to published and proven to be safe.

MAPS is careful to suggest that laboratory-produced MDMA is not the same as street ecstasy, or “molly” as it is also known, because the street drugs are often laced with other chemicals and/or dangerous adulterants. “Pure MDMA has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses,” states the MAPS website.

There will be another phase of research this spring with the hope getting the trial authorized as a legal prescription. Metro News reported that after the trial, 56 per cent of subjects no longer met criteria for PTSD. Followed up 12 months later, these same individuals now accounted for 66 per cent who no longer met the definition for PTSD. Two other recent trial studies, also involving the treatment of PTSD with MDMA in Charleston, South Carolina, also saw a 56 per cent decrease in the severity of PTSD symptoms.

According to the non-profit research and educational organization’s website, “MAPS is undertaking a roughly $25-million plan to make MDMA into a Food and Drug Administration (FDA)-approved prescription medicine by 2021.”

Since 2014, at least 54 Canadian veterans have committed suicide; however, the number could be higher due to lack of public reporting. Since the beginning of 2017, at least two Canadian military veterans have killed themselves, and both were thought to be suffering from PTSD.

Mark Haden said that during the study it was evident the veterans were in suffering due to trauma. “We know that it can be treated, and to watch this process happen in our society with the amount of suffering, and to know that this is available, is a source of great distress for us.”

Next month we’ll look at the study in more detail, and discuss alternative forms of treatment for veterans suffering from post-traumatic stress disorder.