STIFF UPPER LIP BEATS GRIEF COUNSELLING - Peter Worthington

[PPCLI Guy]

2005 was a long time ago.

FWIW, Peter Worthington served in Korea

 

[scoutfinch]

Someone pointed out my error and I apologized for stepping on my.... 'self'.

 

[Armymedic]

So what do you suggest we do?

I suggest that in this topic on this subject you take a step back and take a breath before leaping forward and ripping someone a new breathing hole because they disagree with your viewpoint on this subject.

When I reread the initial post, Mr W article, I see nothing that says that people should not be encouraged to seek treatment. In the article I see an opinion as to the way to help people learn to deal with their issue. Thinking only one way (the soft shoulder and Kleenex technique) of helping people learn to live with their illness is wrong.

Also, I see in the second post a statement I agree with: A for-profit medical system does not make money by curing their patients in one or two visits.

Nowhere do I see anywhere or anything that says people need not seek treatment.

 

[the 48th regulator]

Also, I see in the second post a statement I agree with: A for-profit medical system does not make money by curing their patients in one or two visits.

Nowhere do I see anywhere or anything that says people need not seek treatment.

And this is based on what?

I would like to know where a patient visits the medical community, peer groups, or any other part of the treatment for only one or two visits.  Do you have documentation where this is the norm?  Does the poster who made this statemnt have the facts that this is the norm?

Do you see what I am getting at?

dileas

tess

 

[Armymedic]

No, I do not see what you are getting at.

 

[the 48th regulator]

No, I do not see what you are getting at.

Show me where any form of treament, is cured by a visit or two.

Specifically a debilitating injury.

Would you cure a gunshot wound with a band-aid?  What about an amputation?

dileas

tess

 

[Armymedic]

Nice,
pick on the one phrase and poke it.

Mute point as both Canadian and British medical systems are govt sponsored, and not for profit.

So what do you have against a treatment strategy of "stiff upper lip and getting on with your life" vs the "soft shoulder and kleenex"?

 

[the 48th regulator]

Nice,
pick on the one phrase and poke it.

Mute point as both Canadian and British medical systems are govt sponsored, and not for profit.

So what do you have against a treatment strategy of "stiff upper lip and getting on with your life" vs the "soft shoulder and kleenex"?

Yes,

The one point that advocates not using medical treatment to treat an injury.  Considering your background, I was shocked that you actually subscribe to that philosophy.

Personally, I tried the "stiff upper lip and getting on with your life" for ten years, until I finally resigned and said I needed help.  I found help via "soft shoulder and kleenex" approach, however, the peer groups I have attended, I would have been pucked in the mouth if I stated they had soft shoulders.  We have finally begun to treat the pain that some feel, yet we can not get over the whole “Suck it up” stigmata that still permeates within our military.  Would it not be better to get a troop the treatment he needs, and get him healed, so that he can jump back in the saddle?

As for being governments sponsored, now you have lost me.  What was that statement in regards to?  (I am not trying to be on the offensive, I may have lost my train of thought, no coffee as of yet, ugh)


dileas

tess

 

[Armymedic]

I think I see where we are misunderstanding each other:

I am saying that the treatment option is to be used by those who have come forth for help, as recommend by the care giver... not for people to try to do on their own, without the help of a professional.

Not at all like what you experienced.

The "government sponsored" is in discussing of private mental health professionals (like the U.S. grief counsellors in the first post) who need to make money and do so by having many clients who visit regularly and often.

 

[CountDC]

I will tell you this for most phychiatrists, meds are a last resort.

Most doctors that deal with any type of mental health perfer to treat the person before the symptom, by this I mean that if you have some clinical depression type symptoms before your put on drugs, they generally suggest seeking other resources first such as therapy etc. If you have explore those options yes, then generally the white coats will prescribe drugs.

People are not just given high dose meds and kicked out the door, most people are given a cocktail of low dose meds, and therapy, or other things that fall into that catergory.

S.Stewart

Not the ones I have experience with - they all have done the exact opposite of what you say. Here you go take these and we will see you next month - 5 minute appointments every month just so the psych can write a new scrip and bill the government.  Where was the therapy again?? I even know of one case where the person was institutionalized for a period and the treatment was making sure they took their meds with a 5-10 minute meeting once a week to see if they felt ready to go home. This meeting included the guilt trips of "don't you want to be with your kids, don't you care about them, do you want them to see you like this, don't you want to be a good parent".  Real good treatment there - thank god I finally got them out of that place.

 

[S.Stewart]

Not the ones I have experience with - they all have done the exact opposite of what you say. Here you go take these and we will see you next month - 5 minute appointments every month just so the psych can write a new scrip and bill the government.  Where was the therapy again?? I even know of one case where the person was institutionalized for a period and the treatment was making sure they took their meds with a 5-10 minute meeting once a week to see if they felt ready to go home. This meeting included the guilt trips of "don't you want to be with your kids, don't you care about them, do you want them to see you like this, don't you want to be a good parent".  Real good treatment there - thank god I finally got them out of that place.

That is the practice on one set of healthcare providers, not them all. Most doctors do give a damn about those they are providing care for. In every field your going to find doctors that treat their practice/job like a meat market, not just in mental health. That's one place, not all mental health facilities are like that, you'll also find that most people that use the mental health system do not need to go through a period of being insituted. Most patients due therapy on a out patient basis, with mental health who are based out of hospitals, which are free of charge therapy unlike private practice.

Treating mental health is not like treating for the flu, there are no set symptoms even for diseases that affect the mind, they are well spread out and diverse, and many diseases share symptoms/signs. If I was patient for example I may suffer from manic depression, aka bipoplar, and you may suffer from the same mental health issue, but my symptoms could be compleatly different from yours, you could have have outward symptoms, and I could have none at all.

One bad experince does not set the standard for the medical community. The medical world is hit and miss all the time, something I experince daily, I'm a pain managment case. 

 

[visitor]

Actually neither  "stiff upper lip" or grief counseling individually or together is ideal in treating PTSD. The individual can also benefit from:  relaxation training, cutting out alcohol and caffeine, eating a healthy diet, getting enough sleep, getting lots of exercise to relieve stress,  taking  medication to help sleep (or alleviate depression),  talking  to a professional, talking  to a friend who is going through the same thing,  laughing at a comedy, meditating or listening to music, reading etc.

People do  best when they do a little of each of these things including: wallowing  a while in self pity and  putting on  brave face.

In the end it  is supportive friends and family who  can be  helpful by encouraging all of these strategies in their proper time and place.

If you have a doctor or therapist is not good for you, find another one.

 

[CountDC]

That is the practice on one set of healthcare providers, not them all. Most doctors do give a damn about those they are providing care for. In every field your going to find doctors that treat their practice/job like a meat market, not just in mental health. That's one place, not all mental health facilities are like that, you'll also find that most people that use the mental health system do not need to go through a period of being insituted. Most patients due therapy on a out patient basis, with mental health who are based out of hospitals, which are free of charge therapy unlike private practice.

Treating mental health is not like treating for the flu, there are no set symptoms even for diseases that affect the mind, they are well spread out and diverse, and many diseases share symptoms/signs. If I was patient for example I may suffer from manic depression, aka bipoplar, and you may suffer from the same mental health issue, but my symptoms could be compleatly different from yours, you could have have outward symptoms, and I could have none at all.

One bad experince does not set the standard for the medical community. The medical world is hit and miss all the time, something I experince daily, I'm a pain managment case.   

I can but assume you missed the "not the ONES" as in plural - my experiences have not been just with one person or facility nor has it been confined to one province.

the practice of out patient treatment is disputable - numerous times I have read articles and saw news reports (usually after an outpatient committed suicide or killed someone) where professionals in the field argued it was being over used simply because the government did not provide enough funding to properly care for the patients within the institution. Are they correct?  Don't know but as I said it is disputable.

The medical world is hit and miss but I would prefer it to be a little bit more hit with the people around me by taking the time to hear them before throwing meds at them. Just about everything outside of obvious things ie - bet that knife sticking in you is the problem - has several possibilities.  In the phsyc world they do have a book for diagnosing the patients based on the signs they exhibit so they can better diagnose them. Some patients will have more than one problem which makes it even harder to do.  If ever you can get your hands on the book look somewhere near the end - I was shown it by one of the docs in the ward when I visited - there is a catch all term I forget but it means the patient is a little bit of everything. Good book but you can't get the info in a 5 minute interview.

Using your theory of one bad experience does not set the standard - from my perspective of the "brain" docs one good experience does not set the standard.

I notice you like to say "most" often.  You may want to quantify that with a "that I know" unless you actually know most doctors or whatever you are talking about at the time. Something we are all guilty of at points and I am sure I have probably done the same thing sometime on one of these boards.

In closing - everyone does have to find the treatment that is best for them whatever it is.  Maybe it is crying on the docs shoulder or maybe it is going out for a bender. As long as it does not harm anyone else then go for it.  Myself - from my experience I will still approach the brain docs if I need to but I will take everything they say with a grain of salt. Surely they have to be right at some time - just haven't been my luck yet.

 

[S.Stewart]

I can but assume you missed the "not the ONES" as in plural - my experiences have not been just with one person or facility nor has it been confined to one province.

the practice of out patient treatment is disputable - numerous times I have read articles and saw news reports (usually after an outpatient committed suicide or killed someone) where professionals in the field argued it was being over used simply because the government did not provide enough funding to properly care for the patients within the institution. Are they correct?  Don't know but as I said it is disputable.

The medical world is hit and miss but I would prefer it to be a little bit more hit with the people around me by taking the time to hear them before throwing meds at them. Just about everything outside of obvious things ie - bet that knife sticking in you is the problem - has several possibilities.  In the phsyc world they do have a book for diagnosing the patients based on the signs they exhibit so they can better diagnose them. Some patients will have more than one problem which makes it even harder to do.  If ever you can get your hands on the book look somewhere near the end - I was shown it by one of the docs in the ward when I visited - there is a catch all term I forget but it means the patient is a little bit of everything. Good book but you can't get the info in a 5 minute interview.

Using your theory of one bad experience does not set the standard - from my perspective of the "brain" docs one good experience does not set the standard.

I notice you like to say "most" often.  You may want to quantify that with a "that I know" unless you actually know most doctors or whatever you are talking about at the time. Something we are all guilty of at points and I am sure I have probably done the same thing sometime on one of these boards.

In closing - everyone does have to find the treatment that is best for them whatever it is.  Maybe it is crying on the docs shoulder or maybe it is going out for a bender. As long as it does not harm anyone else then go for it.  Myself - from my experience I will still approach the brain docs if I need to but I will take everything they say with a grain of salt. Surely they have to be right at some time - just haven't been my luck yet.

Talk about cynical. In regards to the media, it's always hard to tell, usually they report on the worse case senerio, but you are correct out patient does not work for everyone, espcially not severe cases. In the same token doctors are not mind readers, they can not tell what a patient is thinking unless there are signs, or that patient opens their mouth to express what is going on in their head. Sometimes people are good at hiding, they don't present, or express severe signs, thus unfortunately do not get the treatment they need, its a sad reality, and one that has led to tragedy. 

In my experince, working within the field of emergency medicine, which included dealing with alot of people who dealt with life changing experinces, as well as everyday mental illness. That it is also the patients responsiblity to take some responsiblity for their treatment, in other words say "Hey doc, I don't think that is quite working for me, can we try something else".

Your right, sometimes it could be more hit, but there are pitfalls in every area of medicine, people get labeled with the wrong thing all the time. For example from my orginal injury I went through numerous x-rays, 3 ultrasounds, 4 MRI's, for and various professionals to finally figure out exactly what was wrong with me, which was obviously more than then the orginal injury I presented with in the ER. That took over a year since the orginal injury, and only now that I have a correctly labeled injury have I really entered into the pain managment phase.

It sucked, but I know there is no one clear cut reason for this, it was not simply a manner of someone not caring and dropping the ball, the intital injury was treated in the ER, and dealt with effectively, but unfortunately do to symptoms shown, and level of pain I was in, swelling made it difficult both for me and the ER staff to get a clear picture.

Also I am sure you know as well as I that the medical world is not always as funded as they need to be, this leads to long waiting lists, and huge patient loads, sometimes its not that doctors do not want to spend the time they simply can't. This is something that I believe should change, and hopefully it will, but time and money generally do not meet on the proper path, when its a matter of paying out.

Your correct, and I have expressed that previously as have others, what works for one will not always work for another. Sometimes the hit and miss, can not be helped.

 

[daftandbarmy]

One of the problems with having an efficient and well resourced psychotherapy program is that it can remove the solider under stress from their peer group too quickly and deliver them into the hands of 'experts' where they can actually suffer more from the lonliness of rapid separation from their buddies.

I've seen guys under stress moved out of a frontline platoon and given a useful job at Coy or Bn HQ where they are still seeing, and being seen by, their buddies on a regular basis. The RMO can also more easiy keep an eye on them informally and recommend other treatment if appropriate. Once they get a little 'decompression' time, many can go back to the platoon (or equivalent) quite successfully. Now, there are clearly cases where this approach will not work, but in many cases it will.

There are quite a few books out there that mention this approach being used extensively in various wars of the past and present, yet I've never attended a 'lecture/demo' advocating this approach, but have seen it used a few times. I'm wondering if it's a technique that is taught these days, or is it something that just emerges as basic common sense during war time?

 

[Kirkhill]

I haven't experienced that which many of you here have experienced.  However I have found myself in the same place as some of you.

I have felt that medication benefited me and felt that medication was useless, and even counter-productive. I have benefited from counselors and ignored their counsel.  I have benefited from friends and family and time - and responsibilities that I couldn't walk away from.  And at the end, like an Alcoholic I know that there is no cure.  At the end you just learn to live with it.  You do end just sucking it up and getting on with it.

But the process of learning how to do that can be lengthy.

 

[Cdn Blackshirt]

Since things have seemed to calm down a little and since I really do want to keep this on-topic, I'll just share some links I found in the last hour (cable modem just installed in new apartment):

Quick Summary of Treatment Options: http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_treatmentforptsd.html

The Treatment of PTSD - An Assessment of the Evidence (Report Brief - 4 Pages):  http://www.iom.edu/Object.File/Master/47/391/PTSD%20Report%20Brief%20FINAL2.pdf

The Treatment of PTSD - An Assessment of the Evidence (Actual Full Report - 189 Pages):  http://www.pdhealth.mil/downloads/TreatmentofPosttraumaticStressDisorder(IOM2007).pdf

I'll reserve comment as I don't want to bias anyone's reading as I appear to have myself in the position of being a lightning rod which I don't want to exascerbate.


Cheers, Matthew.