The following is a transcript of the "Chat with Dr. Cantrell" from Thursday, May 26, 2011. Links to
additional resources and to order Dr. Cantrell’s books are included to the right.
Mickie (Moderator):
Hi Dr. Cantrell, thanks for being here.
Dr. Cantrell:
Hello
jlyn:
Well I do have some concerns. My son returned from Afghanistan last May and is
now IRR. He has had trouble sleeping, haunting memories and lately he is waking up having symptoms
of panic attacks. He can’t sleep without noise and only sleeps for short periods. He has bursts of anger.
jlyn:
I’m concerned his PTSD is getting worse to trigger panic attacks.
Dr. Cantrell:
He is probably having some adjustment issues which are to be expected. Is
he seeing anyone for help with his sleep and anxiety? Sleeping in a quiet place can be very challenging;
many prefer white noise, TV or something because it means that all is status quo. Otherwise when
things get too quiet they feel as if they are going to be ambushed, so he would be hyper alert.
Dr. Cantrell:
It would be great if he was open to seeing someone to start the process
of telling his story. Do you have a veteran friend that you could call who could take him for coffee or
something and encourage him to get some help so he can keep moving forward?
jlyn:
He was seeing someone at the VA, He seems to get worse when he is around his
buddies.
Dr. Cantrell:
He is maybe being triggered a bit by his buddies, and when he is with them
perhaps he remembers some of the things that they went through and has some remorse about not
being down range with his buddies.
jlyn:
He has seen a lot for one so young, It breaks my heart as a mother I see an
emptiness that was never there before...He said he was going to go back to the VA; I hope he does.
Dr. Cantrell:
I can imagine this is one of the most painful parts of letting our children
go, and to see them not be themselves is heartbreaking. The best thing a parent can do is just be there
for them and not be too pushy with getting help. Let him know you are there, but also have another
veteran in the wings that can take over and help him get through this difficult time.
jlyn:
I can’t say anything really, he get angry. He and his father are very close and talk a
lot. Is it typical for one’s PTSD to get worse?
Dr. Cantrell:
Perfect, this is wonderful that he and his father have that type of
relationship. It is best for you to not pry and just make sure his father knows if you have concerns and
then perhaps his dad can intervene and it will not be an issue because their man to man relationship
allows this to be an organic process.
jlyn:
He has also witnessed a very traumatic death of someone recently which does not
help matters.
Dr. Cantrell:
We cannot say that this is how it "always" is because we are all different
and have various ways of dealing with stress, grief, etc. So there is a saying in mental health that "it gets
worse before it gets better". This is because we dig into things in order to bring them to the surface
and help them to move forward and to share the burden. They no longer need to the be the keeper of
secrets.
Dr. Cantrell:
No there is a kindling affect of PTSD, and another traumatic event can
certainly trigger someone to go deeper into the their sadness and stuff the emotions that come with
these types of losses. This is a protective mechanism we have and this all takes time and patience to get
back into the saddle so to speak.
KimG:
How do you convince them to get services when they are in denial that anything is
wrong?
Dr. Cantrell:
The best way to encourage them is to have reading material around, and
they can see they are not alone. My books are written just for this purpose. I think also having another
veteran friend, or a battle buddy that you can call upon and ask them to check on him would be most
helpful to seeing that it is not a weakness that he gets help but a way of keeping himself emotionally
fit so he can continue to serve in the USMC. It is unfortunately part of the culture to not seeing any of
these issues, but you can only keep a ball under water for so long before it pops up with more power
than before. They are in this together, and this helps them get through a lot of their emotions etc. So he
may be fine and just needs time to get up and running again.
KimG:
Ok, thank you. He is IRR and his other IRR buddies also think they are fine, they do
not believe in PTSD.
CaliRunner:
My question is very similar to the mom whose son came back different and I
was wondering about what kind of behavior to expect and how best to deal with it.
Dr. Cantrell:
Yes, they are not the same. They have experienced a lot of things, that they
will more than likely never tell you. So please respect their boundaries, and it is up to them when and
if they decide to share and with whom. It can be different for each Marine in terms of when there are
signs of Combat Stress, but the basic issues that are typical and to be expected are: Sleep disturbance,
hyper vigilance, anger, isolation, avoidance of things that would trigger them, they don't like being
around too many people, road rage, impatience, frustration, nightmares, activation of anxiety and panic
by smells, touch, sound and visuals. So there are a multitude of things that can occur. You may see they
are drinking more, using pain meds, or substances to alter their reality.
Dr. Cantrell:
A great desire to go back the war zone is also very typical and this has to do
with the level of accountability they have to be with their fellow Marines and to be in the fight.
Dr. Cantrell:
As a new mom the best way to support them is to have another veteran in
the family or friend intervene and befriend them, love them unconditionally, keep your eyes wide open
and know when to call in the reinforcements, and don't push them because they will move away from
you. They must go at their own pace and under their own agenda.
down2earth:
I am a new mom whose son just got back from deployment. I am so
desperate for help; he is not the same anymore. He is very angry with anything and everything and he
talks so loud.
Dr. Cantrell:
Has your son been examined for a Traumatic Brain Injury or hearing loss?
down2earth:
No. I try to understand the situation and try to help him. He was very open
with me before he left but not anymore, he was fun to hang out with; he avoids talking to people.
Dr. Cantrell:
It might be a great idea to encourage him to be assessed. PTSD and
Traumatic Brain Injury are the hallmarks of this war and the invisible wounds. They appear good, but
they often have impulsive anger, a change of personality traits, hearing loss, visual issues, and many
other symptoms.
jlyn:
I would really like to recommend your books, they have been extremely helpful and
insightful. Thank you for them.
Dr. Cantrell:
Thank you Jlyn, I am glad to hear my books are helpful. I will have another
one coming out soon, and I do have another one which is a workbook that is a companion book for Once
a Warrior.
Dr. Cantrell:
down2earth, His soul has been wounded, and sometimes they feel that it is
very difficult find joy once they return. They have a great deal of camaraderie with his fellow Marines,
and when they return home it is just not the same. They do not connect with their families, or even
peers in the way they did before they left, because there is nothing to compare his Marine connections
with, none of us will ever know that deep level of connection. They literally lay down their lives for each
other. They feel like they just don't fit in when they return, it is all so surreal.
down2earth:
What should I do to help him?
Dr. Cantrell:
You have to just be there for him, prepare good food, and make sure that
you encourage his Marine buddies to come over and have meals together. Know what your local
resources are for your Marine to get help and like I have said before have another veteran on standby to
reach out to.
down2earth:
That is not possible his buddy is leaving soon for deployment. My son is
home for his after deployment vacation and his buddy is not even going to be here. I am going to do
what’s best for him and try to help him as much as I can.
Dr. Cantrell:
Maybe there is someone else that you can call that can come into the
picture, and get the contact info on his buddy who is leaving and adopt him and encourage your Marine
to participate with sending him packages from home.
down2earth:
Thanks for the suggestion.
Mickie:
There is a new national “hotline” for Marine families to call when trying to
cope with these issues. It's on this page Combat Recovery Resources
Check the state availability at the bottom of the
Dstress home page though.
Dr. Cantrell:
Doing your best is all you can do, make his favorite foods and just love him
or her like a momma can!
down2earth:
Yes, I will do that.
jlyn:
My son also has been diagnosed with a TBI, causing constant severe headaches and
hearing loss. He has seen the books around, but just makes comments about them. I believe he thinks
no one really can know what he went through and at least right now has no interest in reading them.
Dr. Cantrell:
Jlyn my book Down Range to Iraq and Back is on an Mp3 Player and this is
for those who can no longer read or just do better with the recorded word. My other books will also be
released soon too in that format.
Dr. Cantrell:
Headaches are a great distracter and also add to frustration and for those
of us who have migraines we can relate on some level. It is just knowing that they have a safe place to
land really helps a tremendous amount.
jlyn:
down2earth, please try to read Dr. Cantrell’s books.
down2earth:
I will go to the book store tomorrow.
Dr. Cantrell:
My books are all available on this Marine Parents site.
Dr. Cantrell:
jlyn, The TBIs are a major concern and if you see that they are not tracking,
and are forgetful with places, appointments, etc., loss of interest, poor balance, sleep disruption, slow
processing information, please make sure you help them get into the medical system so they can get
help.
down2earth:
What is TBI?
Dr. Cantrell:
Traumatic Brain Injury = TBI and MTBI is a minor traumatic brain injury.
SantaCruzMama:
Dr. Cantrell -- do you have any experience with MDMA-assisted
psychotherapy, are you familiar with the pilot research going on, and if so, what is your opinion of the
future of this therapy for PTSD?
Dr. Cantrell:
Yes, I have read some things on this, it is to help them with touching into
more joy, but this a treatment that I don't think has taken off. This is yet another chemical and how do
we know that someone won't be more activated by this drug. I am not a fan of this proposal.
SantaCruzMama:
Thank you for stating your opinion. You might notice from my call sign /
user name that I live in the town where MAPS is promoting research.
Dr. Cantrell:
Well the research will bring some information. But it just seems that people
are looking for a quick fix and this is a life long journey of healing.
SantaCruzMama:
We will have many thousands of combat veterans in need of healing.
Maybe we need to be looking for some quick fixes. Ssris seem to work pretty well for a lot of people.
But I agree more research is in order before we make MDMA-assisted therapy a mainstream approach. I
just wondered what your take was.
Dr. Cantrell:
Well, PTSD is not something that you "can just get over", it is involves
a fragmentation of the spirit and requires a great of work and familiarization of how each person is
affected. It involves mind body and spirit. This is a very complex situation to think that one believes that
a quick fix will do it, truly sets our troops up for failure, self-loathing and ultimately suicide. It removes
the component of hope, purpose reconnecting with self and higher meaning.
SantaCruzMama:
Multidisciplinary Association for Psychedelic Studies; reputable
organization, but still very small.
Dr. Cantrell:
They used psychedelics in Vietnam and did it get us very far?
SantaCruzMama:
The pilot studies (first done in 50s so we have longitudinal results)
have been quite successful. The Swiss are having good results. It's difficult to overcome the controlled-
drug stigma because of MDMA’s association with the recreational drug ecstasy. I'm not familiar
with "psychedelics" used in PTSD treatment with Vietnam vets -- is there something I should read?
Dr. Cantrell:
I am glad that there are positive results from studies but having worked in
this field for nearly 20 years and talked to thousands of Veterans and also did my dissertation on PTSD in
Vietnam veterans, it is my professional opinion that manmade chemicals do not bolster the mind, body,
spirit connection.
SantaCruzMama:
Thank you.
Dr. Cantrell:
Google LSD and Vietnam veterans.
SantaCruzMama:
You realize of course that LSD and MDMA are unrelated? Would you
also advise against Ssris?
down2earth:
I am with you Dr. Cantrell.
Dr. Cantrell:
I am not here to argue or discuss experimental medications, I am here
to support and answer questions about your Marines and family members. Ssris are a standard
pharmaceutical used for PTSD, but even that is under question. And yes, of course I know that LSD and
Ecstasy are not related.
jlyn:
Dr. Cantrell could I ask another question when you are ready?
Dr. Cantrell:
Please jlyn, what is your question?
jlyn:
My son has been offered a job as a private security contractor in Afghanistan and
is very interested in it. My husband and I are very concerned that this would make him worse. So far we
have just been listening. Should we discourage him...would this make him worse? He seems to think it
would help.
Dr. Cantrell:
Your son is an adult and it is normal for you to have concerns, but this is
more likely something that he feels strongly about and it is very familiar territory to him.
Dr. Cantrell:
Sometimes in ways that you may not understand it gives them something
productive to do, and they are in a situation in which they feel productive and they are using their
already established skills. He may not do this, but the more you object the more he may move in that
direction. There are colleges and universities that are really working hard to also offer training and
education to our men and women in uniform to start a new future.
Dr. Cantrell:
Please Let your son know that he is not alone and we all appreciate his
service. I will keep you in my prayers.
Mickie:
Who has a question that hasn't had an opportunity to ask one? We have 20
minutes, anyone with a question please post it.
Dr. Cantrell:
Thank you all for the great questions tonight.
Mickie:
And your advice has been so helpful, Dr. Cantrell.
Nan:
Ah, yes. Mickie and I remember the days back in '03, when we would find each
other in the middle of the night in this chat room....
Mickie:
I’ve passed many of your comments on to my daughter in law and as for my
oldest son, I’ve been observant.
Nan:
Yes, me too -- to my veteran Marine and to my daughter.
Dr. Cantrell:
That is a powerful visual, and to think that the connection remains after all
these years. We al must really talk this all out and learn from each other.
Mickie:
Definitely, Dr. I feel there is so much to do for our Vets. Their needs will be with
us for many, many years.
Nan:
Yes.
Dr. Cantrell:
Yes, there is so much we must all do, but for the family members here and
afar we must also honor you for your support and the love you give your service members.
jlyn:
Thank you Dr. Cantrell and everyone else for your patience with my questions.
Mickie:
Thanks for being here everyone. The next chat will be announced on our web site
and in the newsletter.
Dr. Cantrell:
It is truly my honor to be here. You are all amazing and I will keep you and
your Marines in my prayers. You are never far away from my heart.
Mickie:
Thank you Dr. Cantrell!
Dr. Cantrell:
You are most welcome.
