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Chat Transcript with Dr. Cantrell, May 29, 2008
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Educational Purpose NOTE: The chat discussion is intended solely for educational and informational purposes and not intended as medical advice. Please consult a medical or mental health professional if you have questions about your health.

No patent liability is assumed with respect to the use of the information discussed. The speakers and/or MarineParents.com assume no responsibility for errors or omissions. Neither is any liability assumed for damages resulting from the participation in the discussion or use of the information discussed.

The following is a transcript of the "Chat with Dr. Cantrell" from May 29, 2008. Links to additional resources and information from the chat transcript are included to the right.

Linda038:
Dr Cantrell, Welcome back. It was good to meet you at our conference in Washington, DC this April.

Dr. Cantrell:
Thank you and good evening to everyone.

Fred45:
Hello, Dr. Cantrell - My wife and I had the pleasure of meeting you in St. Louis last year.

Dr. Cantrell:
It was great being at your conference. I had a great time and met so many wonderful people.

Fred45:
Dr. Cantrell - I'm here on behalf of a friend. His son is back from a second tour in Iraq - he's tried to take his own life twice since.

Fred45:
He doesn't know where to go for help, but the family is watching over the boy 24 hours now.

Dr. Cantrell:
Fred, I am so sorry to hear this. It is a very difficult transition for some, and they feel like they don't know how to fit in.

Dr. Cantrell:
What state are the family from?

Fred45:
Michigan

Dr. Cantrell:
There are programs available with the various vet centers which are based in the community and the VAMC may also have some help.

slp:
My son just finished his four years and is still adjusting to civilian life

Fred45:
I told him to go to the VA hospital in Saginaw and ask for help.

NSW:
Do a lot of them try to take their own lives after coming home?

Dr. Cantrell:
It would also be good if the family could reach out to another veteran. This is a very good support system for these young Marines who are coming home. They feel no one understands. Are you in a position to hook him up with a veteran or are you one yourself?

Fred45:
I am not, but I had the same idea (probably from you!) - I thought about getting in touch with the local VFW or recruiter.

Dr. Cantrell:
Unfortunately, the information on suicides is not too accurate, but I just read an article today which said that it is not looking good. So this is a real concern. This is why people must do their part to understand their Marines.

Fred45:
He apparently has feelings of guilt that are causing his distress.

slp:
Fred, That is a good idea. A vet has invited my son to come to their meeting this week and he is looking forward to going.

NSW:
I'm sorry but the thought of that scares me to death.

Dr. Cantrell:
Yes, please get a hold of the recruiter and there are Marine organizations out there, perhaps Marine Parents.com can help link you to local Marines in that area. This is very important and nothing to wait on.

Fred45:
I'm not sure how receptive the boy will be, but I'll definitely suggest it to his dad. I also sent them the link to MarineParents.com last night as well.

Dr. Cantrell:
Yes, survivor guilt is a tremendous deterrent for getting help, as they do not feel they deserve to be here.

Dr. Cantrell:
Be very proactive. Please do not rely upon them to get help themselves. They are probably in denial and thinking it will go away by itself. This is a very dangerous situation.

Fred45:
Will do - I'll call our local recruiter's office tomorrow morning and ask that he make contact. Same with the VFW.

Dr. Cantrell:
Sometimes, the recruiter may not be too receptive, and be careful about giving away his identity.

spidey:
Fred is the boy getting any therapy

Fred45:
I heard of this second hand - the dad is on a machine start-up for business out of the country right now. His boss called me knowing that I have a Marine and thought I might know what to do.

Fred45:
I don't know if he's seeing anyone for help currently or not - I'd hope so since this is his second attempt.

Dr. Cantrell:
Chances are that he may not be seeing anyone, otherwise there would have probably had more checks and balances in place.

Fred45:
Dr. - can you suggest a way of being proactive and still protecting his identity?

Dr. Cantrell:
Ask for local resources, such as the Marine Corps league. Ask the parents to contact his buddies, and get some support that way and if he is suicidal they should take him directly to the nearest hospital for evaluation.

Fred45:
I also suggested that they take him to the VA hospital immediately - I'll follow through with your other suggestions - thank you!

wounded_devildogs_wife:
My Husband was hit last year by a ied and was recently dx with PTSD and doesn't sleep at all he is having issues with pain and anger this is normal right

wounded_devildogs_wife:
He’s being seen for traumatic head injury and is on a medical hold now

Dr. Cantrell:
This is the hallmark wound of this war and this needs to be carefully assessed. Yes, it is normal, but the anger must be kept in check.

slp:
Is there any kind of time frame for them having trouble with sleeping

Dr. Cantrell:
Yes, please follow through and make sure that he is taken care of.

Dr. Cantrell:
Sleep is certainly an issues can clearly make anger more intense because of the lack of it.

Dr. Cantrell:
It is important that he find better quality sleep, and this may mean going to see a doctor who can prescribe some sleep meds until it is all gets better

Dr. Cantrell:
The issues with IEDs is that with the blasts they are finding that some of the symptoms are closely related to PTSD, and they may get worse over time if not addressed.

NSW:
My son absolutely adores his 3 little sisters their ages are 3,5,6. How do I prepare them for their big brothers return? They always used to jump on him in the mornings to wake him up and sneak up behind him, should I be concerned about this when he comes home?

Dr. Cantrell:
Absolutely

Dr. Cantrell:
This is not a good way to start out a welcome home. Our warriors are on auto pilot and with the training and experiences. They are not going to think things through before responding.

Dr. Cantrell:
Usually their startle response is quite exaggerated when they return, so they are on guard and may interpret something so innocent as being something else. Please make sure that his door is locked and that they are not allowed to surprise him like this.
NSW: So how do I prepare my daughters for their brothers change?

Dr. Cantrell:
You must run interference and talk to them and assure that he has his privacy. This could be potentially dangerous. I am sure that many of you have experienced or heard of people waking up their warrior and the outcome has not been good.

Linda038:
the_traveler: question for Dr Cantrell: Is sleepwalking normal with someone who has been deployed?

Dr. Cantrell:
No it is not a normal response. But it does happen. If they are up and around they may be checking the locks and door, but to sleep walk is not a regular presentation.

spidey:
What are first indications we should look for

Dr. Cantrell:
In terms of what?

spidey:
that they are having a hard time readjusting

Dr. Cantrell:
Sleep is a major issue, anger, isolation, alcohol abuse, drugs, road rage, and numbing out are some of the signs, but not all

caroldrotar:
Okay I have a question for Dr. Cantrell. My son is deployed for his third time, when he returned last year one of the first things he said to us was, "I love you guys and it is good to be home, but I want you to understand that I do not want to talk about this last deployment at all" Is that normal?

Dr. Cantrell:
YES< it is a very normal response to not want to talk about their deployments. I am glad he was able to convey this to you and give you fair warning that he did not want to be questioned

caroldrotar:
That is good to hear. Thank you Dr. Cantrell

Dr. Cantrell:
I ask that you do not ask him questions pertaining to what he did. Some of the things they do, they do not want to discuss

Dr. Cantrell:
You must respect these boundaries.

caroldrotar:
I never have and I never will ask questions, I understand that if he wants to share, then he will. Otherwise I will just love him to death

caroldrotar:
That really was not a good word to use "death", sorry.

Dr. Cantrell:
This is just perfect, just love them to death and unconditionally. They are different now and they have experienced things that may cause some unrest within themselves, and they just need to know that they are loved and respected

Dr. Cantrell:
I understand, but loving them is perfect!

caroldrotar:
Thank you for your support Dr Cantrell,

Dr. Cantrell:
You are welcome.

Linda038:
Annandall: Can you ask Dr. Cantrell how she views dissociative identity disorder in comparison to PTSD

Dr. Cantrell:
DID is an interesting diagnosis, and I have worked with this. Usually from my experience, it is a result of extreme trauma, and was a necessity in order to survive the intensity of the situation.

Annandall:
I've thought of it before along the same continuum ... would that be true?

Dr. Cantrell:
Not exactly.

Dr. Cantrell:
PTSD is a diagnosis that has different criteria, than DID. DID is when a person splits off from themselves and various personalities emerge who take on various roles in order to get through the horror of something.

Annandall:
When people with PSTD are having flashbacks - that is different from splitting from self?

Dr. Cantrell:
Various personalities emerge, there is a loss of time, out of touch with reality, distinct personalities which may be male or female in gender, etc.

Dr. Cantrell:
Absolutely, this is a part of PTSD. Please do not think that DID is invovled here. A flashback is triggered by something that may bring back an event and they think they are back at that point in time reliving and acting as if they are there

Dr. Cantrell:
Yes, it is different. With being a Multiple, you have various parts of yourself that emerge at times of stress or whatever, and the object with treatment is to merge these and have a main or dominant personality keeping things at bay. This is much different than Combat trauma.

Annandall:
what are the goals with combat trauma?

Dr. Cantrell:
The goals in working with Combat trauma is to help the warrior understand the triggers that set them off, and link them to an event or experience, in order for them to learn about themselves, and work at managing their traumatic responses and the intensity of them

Annandall:
Wow. Ok, that makes sense

Dr. Cantrell:
They will learn what Combat Operational Stress is, or PTSD, and how to deal with it in their lives.

Dr. Cantrell:
So as you can see the focus is much different. Not to say that someone with DID does not have PTSD, because more than likely than not they also have PTSD

Annandall:
I've heard that before..

The Traveler:
Thank you Dr. Cantrell for you time tonight and all you do for our warriors.

Annandall:
Thanks for answering my questions

Dr. Cantrell:
It is an honor for me to be of help thank you so very much

_A_David:
Hello doctor. I have a question I went to Miss Saigon and had a flashback when the scene of the helo was landing at the embassy I was never there but I flew around in them.

_A_David:
The sounds and visual was very intense.

_A_David:
Is that normal?

Dr. Cantrell:
Yes, these are very intense triggers. This is how flashbacks happen. The sounds and all of the chaos must have reminded you of something in your experiences. Many of my warriors get very triggered by the sounds of Choppers.

Dr. Cantrell:
How did you get yourself back to reality?

_A_David:
My wife hauled me out of there and took me about ten mins to calm down

Dr. Cantrell:
Wonderful that your wife was able to remove you without resistance. You are very fortunate to have someone who cares and understands so deeply

_A_David:
I am not sure but I think she had help the clo was ready for anyone who might flashback

Dr. Cantrell:
What is the "help the clo was ready... “?

_A_David:
vets who understand and sat with me and just talked normal to me

Dr. Cantrell:
This is perfect. This is why it is so important that veterans are also there to help our warriors coming home as well.

_A_David:
they had just done another play written by some vietnam vets and they were not ready for some of the responses that they had

_A_David:
this time they called another project and got some advice

Dr. Cantrell:
This is good so there are clarifications about content etc.

_A_David:
another question is should I share this with my Marine now that he is home from tour #2?

Dr. Cantrell:
David you mean share about your flashback?

_A_David:
yes

Dr. Cantrell:
This is such a valuable experience for your Marine to hear, because it normalizes his experiences. Please share this with him.

_A_David:
ok was not sure if i should

Dr. Cantrell:
Timing is everything, so be sure to observe before you share this, but I think it is very valuable information

_A_David:
and yes i went to the local vet center and now in a group of vets there that meet there

Dr. Cantrell:
This is great help to be in a group with other veterans
Doc3:
How do you approach an employer whose employees are deliberately dropping things behind a soldier that just got back and has gone back to work… just to see him jump or hit the floor? Without embarrassing the soldier?

IronMike:
fire 'em

Dr. Cantrell:
This is infuriating and I have dealt with these issues. I have taken these types of things to Human Resources, and I wrote a letter to the State of Washington on behalf of one of my soldiers who was being harrassed. This must stop.

Dr. Cantrell:
Do you work with this soldier?

IronMike:
That is In-Humane & Cruel to the Veteran !!!

Dr. Cantrell:
YES INDEED and it must be reported and through the proper channels.

Doc3:
No...I am a doctor and this has come up several times in this area

Dr. Cantrell:
I have heard this as well from some of the warriors I see, and it must be handled, or they have a tendency to take these issues into their own hands, and they lose big time. They must be protected and their employers must be informed of this dangerous and inappropriate behaviors

IronMike:
My suggestion would be for the company to issue ONE blanket warning to ALL of the consequenses including the in-herent danger of this type of JUVENILE behavior. Then FIRE those whom are witnessed to be non-compliant; & with no chance of re-compensation if re-hired.

Dr. Cantrell:
Great idea. Our Veterans must be protected from these types of interactions.

IronMike:
I realize that some would oppose me as being too harsh on the alleged offender(s); but, I have seen TOO Many of my own generation So, BADLY Mis-treated for FAR TOO Long. Therefore I Feal Very STRONGLY about ANY Mis-Treatment of Our Veterans; & Any other troubled co-employees that are Trying Their Very Best to cope & carry-on with their individual lives!

Doc3:
What if the Veteran objects to being singled out to be "protected" by his employer? If the employer issues the order then will he not feel even more "different" than he already does?

slp:
What would any of you recommend to a recent vet who is not ready to do group therapy with others, and is struggling with the adjustment back to civilian life??

IronMike:
The blanket order could be addressed to every one except in the presence of the Vet; especially since he/she are not likely to be perpitraiting such Cruel Behaviour.

Dr. Cantrell:
If it is a blanket statement against harrassment then there is not reason to single out anyone, but I feel that our veterans need to be in a protected class and that there should be harsh consequences for anyone teasing or testing the limits of those who serve in our armed forces.

IronMike:
A-MEN !!!

Doc3:
I agree...

Dr. Cantrell:
I would suggest that you help him find one or two other veteans who will take him under their wing. This is a great mentorship.

IronMike:
Good Idea

gumhealer:
Scheryl, that was one good thing that came of Ben's accident. After he broke down, the Marine Corp League men really helped him by talking over things

Dr. Cantrell:
Employers must be encouraged to implement policy that protect them. It is heartbreaking to hear that after serving they must remain on guard at their place of employment, this is not acceptable.

IronMike:
I have been subjected unto the realm of in-humane treatment; although not for the same reasons.

Dr. Cantrell:
Did you got through your HR person and get it resolved?

Doc3:
I agree and I have encouraged several of them to talk to their employers because it is not only traumatic for the Veteran but dangerous because you never know what the Veteran might do to defend himself

IronMike:
Actually, through my Union ombudsman.

Dr. Cantrell:
Great, I am glad you went through the channels, this way you have more recourse

IronMike:
I have always been a gentle spirit; but I too, have a limit.

Dr. Cantrell:
Of course you do and we must all know what your limits are, and to be treated with disrespect is not acceptable.

IronMike:
That's all I wanted for anyone to understand; that some were approaching & even encroaching upon said limit.

slp:
Sue, thank you. That was actually Evan that asked the question. I had a feeling that he was feeling that way, but not sure. Thank you for the answer Dr. Cantrell

Dr. Cantrell:
Which answer?

slp:
About not wanting to be in groups and having trouble adjusting to civilian life. He has only been out for a little over a month

Dr. Cantrell:
Oh I see. This is normal to feel like they don't want to be in groups.

Doc3:
I have also run into a problem with cell phones in hip holders. One man thought someone was reaching for a gun and had a pretty vivid and demoralizing flashback. Has anyone else had to address this problem?

slp:
He has never been one for big groups anyway.

Dr. Cantrell:
So whatever was an issue before they were deployed, they are more likely to have more issues around this after they get home.

IronMike:
Our veteran has been telling me that he cannot stand being in any large group since returning to civilian life.

IronMike:
He was never that way before war.

slp:
How long has he been out IronMike

Dr. Cantrell:
This is normal for a veteran to feel uneasy with large groups. Sometimes the exception is a group of veterans.

IronMike:
2 1/2 years

slp:
He has been invited to a veteran group, but not sure he wants to go

Dr. Cantrell:
This is interesting about the cell phone in the harness. I have not heard this before.

Dr. Cantrell:
But it makes sense

IronMike:
He rarely leaves our home; for anything.

Dr. Cantrell:
He will decide what feels best, but to be totally isolated is not a positive goal. They must learn to push themselves beyond their comfort zone

IronMike:
This I've tried to reasonably encourage of him

slp:
Mine is going out, but spends a lot of time with his sister and some of her classmates when at school with her

Doc3:
The biggest problem I seem to run into is convincing them that their responses are understandable and rather than be embarrassed they should talk it over with someone who would understand.

IronMike:
Jess, is an older young man; who has lost contact with most others his own age, locally.

IronMike:
He is 29

Dr. Cantrell:
Gentle encouragement is the best. Talking about their responses is very important.

gumhealer:
Mike, my son is 23 and feels really old at school

Dr. Cantrell:
We have about three minutes let for tonight

Dr. Cantrell:
Yes your son has far surpassed his class mates.

gumhealer:
Thank you so much, Dr. Cantrell for your time.

Dr. Cantrell:
Good Night everyone and I will keep you and your Marines in my prayers

slp:
Prayers to you also IronMike and your son. and everyone

gumhealer:
good night!

slp:
goodnight Dr. Cantrell and thank you again

Dr. Cantrell:
you are most welcome, and good night.

   
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