Veterans and mental health activists offered widespread support after Fletcher first announced in March that he would seek treatment for post-traumatic stress disorder and alcohol abuse, citing childhood trauma and military war experience. Was taking medical leave. But the reaction was short-lived when, days later, he was prosecuted for sexual misconduct, sparking a debate about the symptoms and stigma associated with PTSD and allegations that he used trauma allegations to excuse abusive behavior. used effectively.
Some employers are already skeptical about hiring veterans, with retired Marine Major Phil Kendrow, a leader of local veterans’ organizations in San Diego, saying military trauma will affect their job performance. Veterans tell him that in job interviews they are asked about their combat experiences and stress levels.
Kendrow said Fletcher’s invocation of his traumatic experience, released days before the charges against him were dropped, “reinforces the stereotype that veterans are broken and suffer from post-traumatic stress.”
As a supervisor, Fletcher fought to reform mental health and substance use services, launching new models of crisis treatment and long-term care. While their work has not focused specifically on post-traumatic stress disorder, activists say it casts a shadow over efforts to understand and treat the disorder in light of allegations of misconduct.
“I could have taken a leadership position and said, ‘I did wrong,’ and it had nothing to do with post-traumatic stress,” Kendro said, adding that his delusion “taints everyone who deals with it.”
Veterans activists and medical experts affirm that PTSD is a real and sometimes disabling illness, but stress that there are effective treatments to control or resolve its symptoms.
According to the National Institute of Mental Health, people can develop this disorder after a life-threatening event, such as a combat experience, accident or assault. The fear that can arise in such situations can help protect people from immediate danger. But sometimes this response doesn’t end when the threat is gone, leaving people in a constant “fight or flight” loop.
“What PTSD does is make things seem dangerous,” says Sonya Norman, MD, a professor of psychiatry at the UC San Diego School of Medicine and a PTSD therapist and investigator with the Veterans Affairs Health System in San Diego.
Loud events are uncomfortable, Kandro says, and fireworks can sound like gunshots, causing patients to replay memories of terrifying experiences.
Norman said people with PTSD may be restless, nervous and have nightmares, flashbacks or insomnia. They often feel emotionally isolated from those close to them and lack joy or pleasure in life. Some people isolate themselves by avoiding situations or places that remind them of the trauma.
“Over time, this type of hedge can snowball into itself and become very limiting,” Norman said.
While some people become depressed and withdrawn, others take risks that trigger the emotion, he said. “Sometimes veterans talk to me about how fast they go on a motorcycle without a helmet so they can feel something,” he said. “It may be an aspect of PTSD, that kind of risk-taking.”
Norman said some patients employ strategies to hide their problems, acting at a high level of suffering in private. Irritability and anger are common, causing problems in relationships, but there is little evidence linking PTSD to violent behavior.
“The relationship between PTSD and violence has been researched, and when the research controls for other factors, there isn’t much of an association,” he said.
Still, Kandro said Fletcher’s reference to post-traumatic stress disorder in light of the impending allegations of sexual misconduct could make employers or coworkers wary of veterans with the position. “People ask, ‘Is this person going to have a sexual harassment problem if they’re hired with PTSD?'” Kandro said.
Ron Stark, president of the San Diego Veterans Coalition, called the situation “too brief to even begin any speculation” about Fletcher’s motive or condition, which he said is subject to medical confidentiality protections.
“Combat veterans experience high-intensity trauma, and it doesn’t affect everyone the same way,” Stark said, adding that a person with PTSD “is more likely to harm themselves than anyone else.”
Part of the conversation surrounding severe trauma is how to characterize the experience and its effects. Kendrow said that some veterans prefer to use the term “post-traumatic stress” – the phrase Fletcher used in his ads – to avoid the negative connotations of the word “disorder”.
However, PTSD is a recognized diagnosis used to determine a patient’s condition and care. Norman said he is less concerned with the naming than the treatment.
Prolonged exposure therapy can help people deal with common situations that they perceive as threatening, in order to reduce their sense of danger. Cognitive processing therapy guides patients to change their beliefs about traumatic experiences. And eye movement desensitization and reprocessing, or EMDR, uses eye movements to change the way the brain processes and stores memories of trauma. Medication can also help control symptoms, he says.
Peer support is also important for combating combat trauma and preventing suicide, Kendro said. “The peer support system of reaching out has been helpful for all veterans, whether they have PTSD or not,” she said.