Recovery through acting

Written by Eric on May 26, 2012 in: Uncategorized |

You might say that Matthew Pennington found his own life while playing another.

A severely wounded combat vet, Pennington was deeply into post-traumatic stress disorder – but didn’t know it. Life seemed pretty normal to him, just as it does to someone suffering from hypothermia. You don’t know you’re in trouble until you’re really in trouble.

Then Nicholas Brennan, a film major at New York University, invited him to play the main character in a film he’d written called “A Marine’s Guide to Fishing.” It starred a young Marine who came home to Maine after the war in Iraq with one leg missing and a severe case of PTSD.

It was a neat fit. Pennington is a former Army sergeant who served three tours of duty in Afghanistan and Iraq. A roadside bomb removed his left leg, shattered his right leg and scorched his lungs. After a year of inpatient and outpatient treatment at the Walter Reed Medical Center in Washington, D.C., he also came home to Maine.

When I went back to Maine, I thought I’d be helping others. Instead, I was the one who needed help,” Pennington told me last week. “I never re-acclimated. I just came home and started shutting down.”

Pennington’s relationships, particularly with his wife, were deteriorating rapidly. Drinking heavily, he seldom left the house except for late-night runs for food and beer. “I didn’t like civilians, and I didn’t like to deal with them,” he explained. “I saw a lot of ungrateful people who had every privilege and amenity, but they’re always complaining and bickering. So to avoid dealing with them, it kept me pretty well housebound.”

Working with a group of New York City vets, Brennan had created a script that Pennington could identify with, so he decided to try his hand at acting. “I thought acting would be so out of the normal that it would force me to deal with things,” Pennington told the New York Times, which profiled his story six months ago. “I wanted my life back.”

Pennington and Brennan were in Charleston, W.Va., last week to screen their film before an audience at the Covenant House, an inner-city institution that provides help to the homeless and indigent.

“As I acted this part, I was able to identify with PTSD for the first time,” Pennington told the group. “I realized what it was, and I recognized that I had it. I went to the VA for treatment, but I always came out with a big bag of drugs.  So I began to go to the Vet Center. They can’t prescribe drugs, but they taught me coping skills.”

Now drug-free, Pennington relies on what he calls the “three-step trick” to help him focus on the present instead of sliding back into traumatic memories. When he begins to feel antsy, he closes his eyes and conjures up a strong memory of home.  Then he opens his eyes and checks his wristwatch for the time and date. Finally, he checks to see where he is at that particular moment and how he is going to get home.

“That puts me in the present instead of the past,” he explained.

But it took some time for Pennington to learn it. “There’s one scene (in the movie) in which the main character tries to go fishing and wind down, but he can’t wind down,” he said. “Instead, he’s always thinking about over there. That really hit home with me.”

The 15-minute film, which Brennan said finally came together after 14 drafts and two years of research and writing, sparked a lot of comments and questions from the audience. Two Vietnam vets talked about how much they identified with the main character, although PTSD did not become a medically recognized disorder until 1980 and they didn’t realize the extent of their emotional wounds.

But even having the diagnosis is a double-edged sword, Pennington said.

“There’s a stigma to PTSD,” he said. “People read about vets with PTSD shooting themselves or shooting someone else or running amok, and they treat you like you’re some kind of psycho. It’s not a label you want to be associated with. Any vet who can tough through it and not admit he has PTSD is going to go that route.”

The film screening was sponsored by Patriots for Peace, an anti-war group that has been active in opposing the Iraqi war. “For years, we’ve been protesting the war and demanding that we bring our kids home,” said Jim Lewis, a retired priest who was one of the organizers. “Now we felt it was important to change our focus and work on how to help the vets once they get home.”

To learn more about the film or to buy a DVD, visit this Web site:



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Army changes PTSD policy

Written by Eric on May 15, 2012 in: Uncategorized |

Recently, I wrote about a whitewater rafting program in Montana, the X Sports 4 Vets program, as therapy for post-traumatic stress disorder, and I remember talking with a vet named Steve Hale, who deployed to Iraq in 2004-05 with the Washington National Guard and who came home depressed and unable to socialize with others. The river outings gave him great exercise, an adrenaline rush and a feeling of teamwork with his rafting buddies, who were also vets.

“Every time I get out on the river, I come home with stories and big pleasant memories,” Hale told me. “It does me a lot more good than the pills they’ve been throwing at me.”

Perhaps, just perhaps, the Army is beginning to get a piece of this picture.

Last month, the U.S. Army Medical Command issued a report changing its policy on pharmaceuticals. It said that only Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) have shown evidence that they do enough good for a patient to justify the prescription.

It strongly cautioned against prescribing benzodiazepines and atypical antipsychotics, saying that they do more harm than good. “There is evidence to suggest that benzodiazepines may actually potentiate the acquisition of fear responses and worsen recovery from trauma,” it said. As to atypical antidepressants, and specifically Risperidone, it said: These medications have shown disappointing results in clinical trials in the treatment of PTSD.”

Last weekend, the Philadelphia Inquirer quoted the assistant secretary of defense, Dr. Jonathan Woodson, as saying that prescription rates for atypical antidepressants increased 10 times between 2002 and 2009: from 0.1 percent to 1 percent. It said AstraZeneca’s Seroquel was prescribed to 1.4 percent of Army personnel and 0.7 percent of the Marines in fiscal 2010.

AstroZeneca reportedly made nearly $6 billion on 14.1 million prescriptions for versions of Seroquel last year.

It told the Philadelphia Inquirer: “Seroquel is not approved for the treatment of PTSD or indicated for use as a sleep aid. Atypical antidepressants, like many other medications, are often prescribed by mental-health professionals for indications beyond those set forth in the FDA-approved labels. Like patients, we trust doctors to use their medical judgment to determine when it is appropriate to prescribe medications. Patient safety is a core priority for AstraZeneca, and we believe that Seroquel is a safe and effective medication when used as recommended.”

Risperidone was the second most-prescribed antipsychotic drug during that period with 12.2 million prescriptions written nationwide.

The Army also broadened its preferred list of psychotherapies for soldiers, saying that trauma-focused PTSD treatment can include narration (including imaginal exposure), cognitive restructuring, in-vivo exposure, relaxation or stress modulation skills, and psycho-education. It specifically mentioned programs such as Prolonged Exposure Therapy, Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing (EMDR), or “other forms of trauma-focused cognitive behavioral therapy, all of which have been shown to have generally equivalent effectiveness.”

Since PTSD often occurs in conjunction with other mental health problems, it encouraged multidisciplinary approaches, including hypnosis, art therapy, bio/neurofeedback, yoga, acupuncture, and massage.

The new policy noted that some patients may prefer such therapies to pharmaceuticals. “Matching evidence-based components to patient preferences is likely to help in fostering engagement and willingness to remain in treatment, which ultimately is one of the strongest predictors of overall treatment efficacy,” it said.

Attached to the report was a chilling article written last year for JAMA, the Journal of the American Medical Association. Dr. Charles W. Hoge of the Walter Reed Army Medical Center concluded: “With only 50 percent of veterans seeking care and a 40 percent recovery rate, current strategies will effectively reach no more than 20 percent of all veterans needing PTSD treatment.”

According to the Army, up to 25 percent of the more than 2 million troops deployed to combat zones in Iraq and Afghanistan may experience PTSD “with combat frequency and intensity being the strongest predictor of this condition.”

But four years ago, the Rand Corp. interviewed 1,965 vets and projected in its controversial 2008 report that 18.5 percent of all returning service members would meet the criteria for either PTSD or depression (14 percent for each, but there’s some overlap), and that another 19.5 percent would experience a probable traumatic brain injury while overseas. Again after taking into account that overlap, it said 31 percent of all returning troops would suffer from one or all of those ailments.

The VA’s actual treatment figures show 28.5 percent of the returning vets are seeking mental health care, which is right on track with the Rand Report. But while the Rand Report projected that some 320,000 American soldiers would need help for TBI, the VA says only 54,070 vets (a little over 4 percent of the returning vets) qualified for that diagnosis.







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Struggling war hero

Written by Eric on May 6, 2012 in: Uncategorized |

We’re walking along a dusty gravel road in the valley between two West Virginia ridges when the Iraqi War hero that I’m interviewing suddenly notices something troubling.

“I planted a bamboo shoot beside that stream and arranged some rocks as a memorial to a fallen soldier who was a friend of mine,” says James. L. McCormick, his voice tightening a little. As I look down toward the stream, I can see a hole where the bamboo has been ripped out and the stone memorial has been kicked apart.

McCormick has seen a number of friends fall, but many more foes drop. He won his first Bronze Star and a Purple Heart for leading attacks on enemy bunkers during Desert Storm as a scout squad leader. Then he was awarded two more Bronze Stars and two more Purple Hearts for his service in Iraq. And the retired Army captain has also been nominated for the Distinguished Service Cross and the Silver Star, the nation’s second- and third-highest military awards for valor.

“This guy is the Audie Murphy of the truck drivers,” says Rich Killblane, the U.S. Army Transportation Corps historian based in Fort Lee, Va. “No truck driver has been in as many ambushes as he has, and all the big ones.”

These days, McCormick has bought a 15-acre farm a few miles east of the Ohio River for his own peace of mind and to help his fellow vets. He calls it the “Raising Cane Farm,” and for erosion control on steep hillsides, he plants as much bamboo as he can afford at nearly $20 a plant.

“I provide jobs for some vets out of my own pocket,” he says. “Others just come out here to walk and relax. And we bring a bunch of guys out here for the deer hunting each fall.”

Taking care of his fellow vets remains important to McCormick. “I’ve told a bunch of my battalion commanders that just because you retire doesn’t mean that you can retire your responsibilities,” he says.

Those responsibilities weigh heavily on McCormick, especially when someone desecrates his memorial to a fallen comrade.

“I’m about half tempted to mount an ambush, catch this guy red-handed if he returns, and whip him with the bamboo he was attempting to steal,” says McCormick, trying to laugh off a growing sense of outrage.

Killblane says McCormick was no one to mess with. “Before he turned his life over to Christ, if he threatened to kill you, he probably would have,” he observes.

Killblane is writing a book about convoy ambush case studies that teach convoy commanders how to fight ambushes and a history of convoy operation during the war in Iraq. He says McCormick was one of the most instinctive warriors he has seen. “His philosophy was to punish the enemy to deter him from attacking any more convoys,” he says. “Of all the ambushes I’ve researched, it’s McCormick who stands out the most.”

The days leading up to Easter Sunday, 2004, prove Killblane’s point.

First, McCormick and his gun truck crew ran into their first ambush on March 22 when they turned back into the kill zone. That was when the lieutenant was wounded in the calf earning his second Purple Heart Medal.

Despite his protests, McCormick was sidelined while his platoon left on a mission without him.  Then on April 7, after the radical young cleric Muktada al Sadr called for a jihad against coalition forces, McCormick and picked up an all volunteer crew to provide security for a convoy hauling supplies to Baghdad International Air Port (BIAP), where the convoy ran into an L-shaped ambush with a sniper positioned on an overpass in front of them.

McCormick was hit in the chest, with his body armor absorbing the blow. Still he was knocked backward off his feet, while a second round hit his machine gun ammunition belt, sending shrapnel into his hand, says Killblane.

“Remembering what a Vietnam veteran told him, when insurgents approached, McCormick fired a flare at them and they scattered thinking it was a rocket,” Killblane says. “That gave him enough time to re-load his machine gun, and then he splattered the sniper who was then about to shoot his driver.”

The next day, Good Friday, all hell broke loose as the enemy ambushed any convoy trying to get in or out of BIAP. The next day, all convoys were shut down but the 1st Cavalry Division, which drew its supplies from BIAP was running critically short.

On Easter Sunday, McCormick and his crew volunteered to escort a convoy hauling critical ammunition to the Green Zone, just eight miles away, but about noon a sea of insurgents began storming their compound with the intent to breech the wall and kill the hundreds of truck drivers parked behind it.  “When his Humvee gun truck mounted the ramp overlooking the wall, all he could see were Iraqis in black.” says Killblane. “For five to ten minutes, McCormick and his crew held off the attack by themselves and then for the next forty minutes only a dozen truck drivers defended the wall.”

Thirty minutes after repelling that attack, McCormick and his emotionally exhausted crew provided security for an ammunition convoy running a gauntlet eight miles to the Green Zone. Since the commander broke his convoy into four smaller convoys, the gun trucks had to make the dangerous run four times.

“They were driving thin-skinned (not armored) trucks, and they got hammered while other armored gun trucks turned tail and ran,” says Killblane. “On the next run, they got ambushed again, but McCormick turned his gun truck into the enemy and it seemed to work because there was less gunfire on the next convoy, and the fourth run was almost incident-free.” By the end of the day, four of the five crew members in his gun truck had been wounded and would still follow him anywhere, says Killblane.

For the ambush going into BIAP, McCormick was awarded the Bronze Star. McCormick later earned another Bronze Star, but has been nominated for the Distinguished Service Cross for his action on Easter Sunday and the Silver Star for his leadership during 40-minute firefight on January 30, 2005. “Lt. McCormick’s warrior spirit and leadership under fire saved hundreds of lives, protected critical military cargo and inflicted heavy enemy casualties upon a ruthless and determined enemy,” said the citation nominating McCormick for the Distinguished Service Cross, which is still pending review.

“His actions were probably the most heroic of any truck driver in Iraq,” Killblane says. “He was grossly overlooked.”

After he left Iraq, McCormick says he spent a year and a half in the VA’s poly-trauma unit in Huntington, W.Va.  “I couldn’t do anything for myself,” he explains. “I slept with a loaded revolver and drank heavily and smoked like a freight train. I had panic attacks and I couldn’t find anything to bring me down, so I did a lot of heavy drinking. When I had nightmares, they terrified my wife, and she’d go out and sleep on the couch.”

Buying the farm between Huntington and Point Pleasant helped.

“This is a place where vets can come and realize that we’re finally at peace,” he says. “This place has so much more healing power than anything you get out of a bottle, either alcohol or pills.”

But McCormick’s 13-year-old son Jimmy had been watching him closely. “You’re really upset about that memorial, aren’t you Dad?” he asked, just as I was leaving.

McCormick emailed this resolution to me the next day: “I said yes it did son, very much so, because we planted it for all fallen troops and to see that just brought back a wave of bad memories on how people died that I personally knew. To me when I saw it, I could hear the crying and see the death all over again. It was simply a violation in the worse way to me, and since it is well know what we do out on the farm I couldn’t help but see it as an intentional slap in the face of not only me but every Gold Star family I know.

“My son is very much in tune with his feelings and looked at me and said. ‘Let’s plant another one, Dad, in the same spot and let me do something to honor your friends.’ He walked the length of that stream picking out all the stone to lay the walkway, he planted the plant again and asked me to help him with the cross, and truly he did most of that as well. I asked him what if someone tears it up again. He said well then we will just come back and build again only this time bigger. On Sunday, he bought flower seeds and next weekend we will plant them around the outline of the cross, again his idea. Got to love that boy.”



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