Understanding Fort Hood

Special to Veterans Advantage

	Barbara Van Dahlen, Ph.D. is a licensed clinical psychologist and the founder and president of Give an Hour

For those of us who have the privilege of working with the military community, the last several days since the shooting at Fort Hood have been very painful. We know all too well what the military community has shouldered since 9/11. We know the strain that our military families have withstood since the start of the Iraq War. We also know the damage done because the attack at Fort Hood came from within. Since the attacks, our country has struggled to understand how this could happen and why this would happen. Perhaps we can best honor those who died by ensuring that these questions are answered to the best of our ability. To do this, we must have difficult conversations—which may not have easy resolutions. And most important, we must continue to take action to ensure that future tragedies are prevented.

Where do we begin? The profession of the suspected assailant—he was a psychiatrist—has garnered a lot of attention. As a mental health professional, I felt great sadness when I learned that someone from my professional community could cause such pain and destruction. We in the healing professions are taught that we must take care of ourselves if we are to be of use to others. We are trained to recognize the signs of burnout and secondary trauma. Yet, we are psychological creatures ourselves, who battle our own demons and, at times, succumb to pressures from within and without.

What was the root of the gunman’s torment? Did he turn against his military community because he was mentally ill? Did his behavior have anything to do with the work he did as a psychiatrist in his service to our country? Was he a disturbed man who would have “cracked” at some point regardless of whether or not he spent his days immersed in stories of pain and trauma? If indeed this is the case, then a difficult question remains: Why wasn’t this detected? Why didn’t his superiors or his peers recognize the level of disturbance that led him to take the lives of so many innocent victims? Are current screening methods within the military adequate—and do they occur frequently enough to detect serious mental health concerns in our military personnel?

Many have asked whether Nidal Hasan was overwhelmed by the trauma that he was trained to treat. There has been speculation that the news of his impending deployment pushed him “over the edge,” that he was unable to distance himself from the stories of combat he heard daily. We know, after all, that secondary trauma is a real phenomenon. We know that children and spouses who live with individuals suffering from untreated post-traumatic stress often develop symptoms of post-traumatic stress themselves. These family members may become depressed, anxious, and dysfunctional—all because of the trauma they absorb day in and day out from their symptomatic loved one. We also know that members of the helping professions—mental health professionals, clergy, teachers, case workers, probation officers—are at risk for experiencing stress and trauma because of the work they do. It is an occupational hazard we typically underestimate. Indeed, it is very difficult for those who wish to help to be faced with situations in which they have little control over the circumstances that harm those in their care. Burnout can quickly slide into more serious and potentially debilitating mental health difficulties.

If, in fact, Nidal Husan suffered a psychiatric deterioration as a result of the work that he did treating those who themselves bear the invisible injuries of war, then we must examine how to prevent others from collapsing under the weight of this professional hazard. We must determine how to better support those mental health professionals who are tasked with caring for our returning soldiers. Unfortunately, the military mental health staff is stretched quite thin, making it difficult for caregivers to receive adequate care themselves. Fortunately, the Department of Defense is aware of this dilemma and is looking to the civilian mental health community to explore possible opportunities to enlist our help. Of course, organizations like Give an Hour are ready to serve.

Finally, reports have surfaced in the media that Major Hasan may have been sympathetic toward terrorist organizations and that he may have committed this horrible act in response to America’s current policies in Iraq and Afghanistan. Unless and until Major Hasan is able to respond to queries about his ideology and intentions we cannot know whether these possible sympathies led to this horrific act of violence or whether, as for many of us, political, religious, and philosophical positions incite passionate debate but do not lead to murder. If this was an act of violence against our country, then efforts to understand the roots of extremism must continue if we are ever to see the end of terrorism. Wars cannot change political or ideological positions. We must continue to focus on nation building and the exportation of tolerance and understanding if we are to ever learn to coexist with cultures and peoples whose world views vary so dramatically from our own.

We Americans seek control when faced with disasters and trauma—whether natural or man-made. As a culture, we don’t tolerate uncertainty and we don’t like to feel uneasy. We want as much control as possible over situations that are frightening or threatening. As such, we desire answers: we want to determine who is at fault or who is to blame so a situation can be fixed, someone can be punished if need be, and we can move forward with our lives. Indeed, this approach is adaptive in most situations. By assessing situations, understanding causes, and implementing strategies, we are better able to protect ourselves and are more successful at navigating life’s requirements. In this situation, therefore, it would be appealing—and relieving—to accept one of the explanations offered above for the ugliness that was unleashed on November 5. Humans and their decisions are, however, complex and multifaceted. In the end we may determine that multiple factors (individual, environmental, political) contributed to the assailant’s decision to fire upon innocent soldiers and civilians at Fort Hood.

But by looking at the possible contributing factors—which currently affect so many men, women, and families who serve—and by implementing strategies to screen, support, and intervene more effectively, we may be able to prevent other tragedies, and we will certainly improve the day to day lives of so many who serve our country.

Give an Hour, providing free mental health services to military personnel and their loved ones, at www.giveanhour.org.

Editors Note:Give an Hour is a strategic partner of Veterans Advantage. Learn more about our partnership with Give an Hour.

Veterans Advantage is also hosting a special online PTSD Transition Center for its members, with customized news and resources to help in this vital area.