How local organizations are helping military veterans overcome the lingering effects of war
Lenny Koehler of Elgin served on a Navy patrol boat in Vietnam. He completed 183 patrols in less than a year. These were no pleasure cruises. The soldiers had to maneuver through the jungle, where enemy soldiers hiding in “spider holes” sprang forth and attacked. Buddies died. He feared for his life. “There were firefights — gunfire, explosions, rockets going off,” says Koehler, 71. “It was very tense.”
He left the war zone and returned home, but the war stayed with him. Until very recently, when after nearly half a century he finally came to terms with his anguish, he suffered from night terrors, anger episodes and daily anxiety. Today, connected by technology to his therapist at Edward Hines Jr. VA Hospital near Maywood, Koehler recounts his struggles. For several months, entirely through teleconferencing, Koehler has received therapy for his post-traumatic stress disorder (PTSD) from Hines. It’s much more convenient for him to use the technology at a Hines’ satellite clinic instead of driving to the hospital to see his therapist.
Hines is the national leader in telemental health visits. Last year more than 28,000 veterans used its video technology as part of their treatment for mental and physical health problems. Even so, the hospital and its six suburban clinics swarm with veterans for whom Afghanistan, Iraq, Vietnam, Korea and World War II are part of their past, but still weigh heavily in their lives.
The number of veterans receiving care is staggering. Last year alone, Hines saw more than 58,000 veterans at 850,000 appointments. Other local medical centers, too, such as AMITA Health Alexian Brothers Behavioral Health Hospital Hoffman Estates, regularly see veterans for PTSD and offer cutting-edge treatment. The lingering effects of war form a complicated story that couldn’t properly be told in a 1,000-page book, let alone a magazine article. Multitudes of vets came home and prospered. Some eventually got a grip on their PTSD while others shunned treatment and struggled. Still others, sadly, don’t receive care because of long wait lists or lack of available services. Acknowledging veterans’ ordeals is a way, however minor, to honor their service and call attention to their continued needs and ongoing sacrifice.
Their wars have ended. But their distress, typically kept private, may very well play out in a home on your block or the block over. “I have a number of veterans who live on my street,” says Dr. Jonathan Hessinger of Lombard, Koehler’s therapist at Hines. “Their service is an important part of their stories and identities.” Concern and care for veterans should be a priority of our communities, says Pam Brockman, Illinois director of Project Welcome Home Troops. “They put their lives on the line for us. We owe them.”
Virtual Reality Therapy
A sign of how society underestimated its potency and failed to properly address it, post-traumatic stress disorder was called shell shock after World War I and battle fatigue after World War II. PTSD afflicts veterans with mood swings, nightmarish flashbacks and sleep disorders. The switch that turns on self-protectively in a wartime environment is hard to turn off in peacetime, and veterans with PTSD often struggle to hold a job, turn to drugs or alcohol or, in the worst-case scenarios, end their lives. PTSD in combat vets runs as high as 18 percent; for all veterans it’s about seven percent, says Dr. Patrick McGrath, a clinical psychologist for Alexian Brothers Behavioral Health Hospital in Hoffman Estates.
In addition to counseling veterans with PTSD, McGrath uses an innovative treatment method called virtual reality exposure therapy. Patients wear a headset, which transports them back to a battlefield complete with gunfire, explosions and, when they’re deemed ready and determined appropriate, even scenes of soldiers being wounded. A veteran might find himself back in a Humvee taking enemy fire. The counterintuitive treatment works, says McGrath, the director of Alexian’s anxiety and obsessive compulsive disorder program. “People say we’re retraumatizing them. They’ve already been traumatized. We’re desensitizing them to the experience. They learn to have the experience without so much emotion,” he says.
About 80 percent of veterans show improvement after the treatment, McGrath says. The change is reflected in better relationships and fewer instances of emotional distress, such as bouts of crying. Vietnam veterans particularly have not sought help for PTSD. The military downplayed its significance, and the public disdained the war and its warriors. In recent times the military has been more cognizant of the profound lingering effects of war, says McGrath, and soldiers who served in Iraq and Afghanistan are less reluctant to seek assistance and more likely to find support among family and friends. Still, the old pick-yourself-up-by-the-bootstraps attitude often roils veterans.
“When they return home, it’s a honeymoon phase. ‘Thank you for your service. I love you.’ After a while, it’s ‘when are you going to get a job? Get off the couch. Stop drinking,’” says McGrath.
Soldiers are stereotyped as macho, capable of brute force and the opposite of peaceful repose. But more than 100 Chicago-area veterans have dealt with PTSD through yoga and meditation. The nonprofit Project Welcome Home Troops holds workshops for veterans where they learn relaxing breathing techniques they can use at home.
“It’s a power breathing cycle — rhythmic breathing that helps them release emotional trauma,” says Brockman of Project Welcome Home Troops. “It helps them manage their stress. They feel relaxed — moments of peace.”
Veterans learn the foundational Victory Breath — a raspy, Darth Vader-type inhalation and exhalation that calms the nerves. Eventually, the hyper-vigilance and rage connected with PTSD recede. “It’s not a panacea. But it helps them back to a sense of normalcy,” says Brockman.
The trauma veterans experience is often misunderstood, and veterans are unfairly maligned. “Veterans don’t call it (PTSD) a disorder. It’s a normal response to a traumatic experience,” says Brockman. “A lot of them have suffered a moral injury. They were asked to kill. That was their job. That goes against the laws of society and the major tenets of religion. That goes against how they were brought up.”
The yoga classes draw scores of grey-haired Vietnam veterans. As they age and retire and find themselves alone with their thoughts and memories, they at last face their past, heavily impinging on their present. “When they were in the military, they were taught not to grieve when a best friend was killed. They would have been a mess,” says Brockman. “Now that they don’t have so much to do, feelings are starting to surface.”
Help at Hines
An American flag soaring outside Hines’ main entrance, veteran after veteran makes his way through its spacious lobby. The vast majority are men over 55. Many wear ball caps indicating their branch of service. Most walk unaided, but walkers, wheelchairs and oxygen tanks are common. The lobby is quiet and businesslike. And, for some, the atmosphere is quite welcoming: a veteran with a black POW hat sits down at a grand piano and plays a few melodious notes before disappearing down a hallway.
In large, expressive letters, a quote from Abraham Lincoln adorns a lobby wall: “To care for him who shall have borne the battle and for his widow and his orphan.” That’s the VA motto.Opened in 1921, Hines initially cared for World War I casualties. Through the years, even today, the faraway battles of Iwo Jima, Pork Chop Hill and Khe Sanh resonate in the halls and treatment rooms of Hines. Veterans share an affinity and take pride in a heritage of service. Hines encapsulates a nation’s debt to its warriors. The care afforded them recognizes not only an individual’s sacrifice but the contributions of generations of soldiers.
Occupying 175 acres, Hines has 483 beds and 3,000 employees within a dozen buildings. Patients come from more than a dozen states for its spinal cord center, and its Blind Rehabilitation Center likewise serves patients from a wide geographic area. The corridors of the blind center contain numerous work rooms for veterans to adjust to loss of vision. A woodworking class is stocked with lathes, table saws and drill presses. A lawn mower is part of the small engine repair room. Another room has a magnifier so veterans with some vision left can accomplish simple but necessary tasks such as reading a bill that comes in the mail. Space also is dedicated to teaching the intricacies of an iPhone.
“The whole idea is to make them comfortable to go back to lead active and meaningful lives,” says Rick Fox, Hines’ public affairs officer and a Marine veteran.
The training kitchen helps blind veterans organize food and utensils, safely use knives and other sharp objects, and pour and measure while cooking. The routine tasks people with sight take for granted are not so routine for the blind. “You need to know how to make a cup of coffee if you live alone, and if you’re married you should know how to pour yourself a cup,” says Fox.
The 30-seat dining hall is a gathering place; patients are not allowed to eat alone in their rooms. “They develop camaraderie. They understand they are not alone in the world. Small things make a big difference for veterans,” explains Fox.
The blind center welcomes veterans for lengthy stays. Other veterans like Koehler don’t need to travel to Hines; he’s never even met Hessinger, his therapist, in person. But they’ve established a rapport through weekly one-hour video teleconferences. “This has been a real blessing. I still have a ways to go,” says Koehler, who, until he retired, was a route driver for a coffee company. “I’ve had to understand why I feel things the way I do. I had to break some habits.”
A Daily Struggle
Leery of what might happen unexpectedly, Koehler sometimes could not stop staring out the window at home. In restaurants he scanned the room in case he needed to make a hasty exit. He became enraged for little reason.
“He never became physical with me. But he’d lose control and had to leave the room,” says his wife, Janet.
To survive in a Vietnam war zone as a gunner’s mate, he had to be hyper-alert. That pattern of behavior had become rooted deep inside him and regularly sprang forth. Ironically, his father had fought at Okinawa and he came home damaged. “He was the sweetest guy. You couldn’t find a nicer guy,” Koehler says. “But he’d feel overwhelmed. He’d break the table. ‘Take me to the ER. I can’t deal with this.’” Finally, almost out of the blue, his father resolved “not to deal with the anger anymore.” Through sheer willpower, he somehow moved beyond his anger.
Looking back at his own journey, Koehler now realizes “I couldn’t do it cold turkey” like his father. In hindsight, his own rage and anxiety made sense. But until he sought out therapy, he had not tried to make sense of his emotional turmoil. Not examining his inner life was the soldier’s way. “It was all a mystery to me,” he says. “When you’re in the service, you’re kind of macho. We don’t talk about it. “You’re worried you’ll be seen as weak, that you’ll be looked down on. When a veteran would finally talk about it, it’s, well, finally someone talked about it. I never said a thing… If I talk about it, it means I have a mental problem. There’s a stigma. A lot of times you pull away from that.”
The attitudes of the times toward the Vietnam War also discouraged Koehler and other veterans from opening up. At his discharge, he was brusquely told: “Don’t look like a sailor. Put away your military items. Put them in the closet.”
Koehler was proud of his service. He had risked his life for his country. But he knew of veterans who were spit on upon returning home. So he tried to bury his past. A turning point was afforded by a veteran he met while visiting a replica of the Vietnam Veterans Memorial in Washington. Koehler was moved by the memorial, and the veteran spontaneously wrapped him in a bear-hug and practically lifted him off his feet. “Welcome home. Thank you for your service,” the unknown fellow vet gushed.
Koehler’s therapy sessions led to self-understanding and acceptance. “It was like a light turned on. I shed a lot of misunderstandings,” he says.But it’s not mere self-awareness, not simply talking about underlying issues, that generates healing, cautions Hessinger. The cognitive behavioral therapy Koehler has undergone involves not only becoming aware of negative thought patterns and habits but supplanting them with positive ones. “It’s not just talking. It’s action,” says the therapist.
Healing is a Process
Koehler understands recovery is a process, a plan of action. “I’m learning how to manage my emotions. I have to get control of them,” he says.
His wife sees the progress. For years, his knee-jerk response after wildly thrashing about in bed at night was “I’m OK. Go back to sleep.” Now the couple, married for nearly 45 years, are enjoying watching their grandchildren grow up. Her husband has learned to “give up control. He doesn’t have to make all the decisions.”
Ironically, it’s the Vietnam veterans who buried their suffering and bore society’s opposition to the war who have made it better for the soldiers who followed them. Dr. Holly Hunley, manager of trauma services at Hines, was once at a session for veterans from Vietnam and younger soldiers who served in Iraq and Afghanistan. A Vietnam veteran lamented the derision they received and their bitter struggles with PTSD. A younger veteran spoke up: “It’s because of how you guys were treated that there’s more of an understanding now for us.”