Dr. Guy Grenny”s Sherwood Road home includes a traditional psychologist”s office, complete with a wall of textbooks and even the expected couch for clients to lie back on and talk to the therapist.
But one young special forces veteran who came in recently on his way back to Iraq for the third time didn”t come to see Grenny as a patient.
The Marine chose the chair, not the couch, while he and Grenny talked a few weeks before Veterans Day.
The soldier had been brought in by his father, a combat Vietnam veteran whom Grenny has treated for post traumatic stress disorder (PTSD).
Dad, who supports his son”s service and that of other children, was worried about warning signs of a condition that has plagued him since Vietnam.
“He didn”t come here to be my client — his father brought him in because his dad was concerned,” said Grenny.
“As I talked with [the son] and I got some information, I could see he has PTSD problems and could be diagnosed. There isn”t any way in the world he wants that recorded, because he doesn”t want it to interfere with his being able to take care of the guys he is with,” Grenny said.
The armed forces, which once ignored or even denied PTSD, has become more progressive in the Iraq war era, offering initial mental health risks and PTSD training to troops. The armed forces now has special units consisting of teams of psychologists who arrive after serious incidents, Grenny said. Thousands of service members will be coming back from Iraq with post traumatic stress syndrome and traumatic brain injuries. But studies show most aren”t seeking treatment because of the continuing stigma from both society and the military itself.
Grenny, who has a doctorate from UC Berkeley, served about 300 veterans as clients for 15 years as the “veterans center” mental health contractor for Mendocino County. Grenny recently retired and closed his downtown office. He still sees about 30 continuing clients but no new ones. His ability to help veterans deal with awful and intrusive battlefield dreams and memories brought referrals from all over the state, many of whom stay in touch.
Since Grenny retired, Mendocino County Veterans Service Officer Carl Stenberg has been referring veterans with symptoms of PTSD to Dr. Vanessa Goertzen..
Grenny said debates over the politics of war aren”t as important to the active soldier as the bond felt by the young Fort Bragg Iraq warrior.
“The guys who are in combat are thinking about looking out for somebody else”s back,” said Grenny. “Somebody else is looking out for their back. A lot of it is about the sense of camaraderie that is built.”
The country woke up to the reality of post traumatic stress disorder on a large scale following the Vietnam War. Veterans centers were established all over the nation where veterans of only that war could drop in and get help. The closest center to Fort Bragg was in Rohnert Park, which was too far away. The VA sent a recruiter to turn Grenny into a contract veterans center counselor.
Grenny, who had recently retired from a career with the old State Department of Mental Hygiene and Sonoma County Mental Health, fit the bill.
At first his local work was limited to those Vietnam veterans who were traumatized not just by a horrific war, swamps and poisonous snakes, but by a nation that Grenny says mistreated them when they got home.
In the late 1990s, the federal government opened up the veterans center program to Korean and World War II veterans to get treatment for PTSD.
“The program was not for them to begin with, but since then I have the older vets,” said Grenny.
He is seeing a World War II veteran who is haunted by memories of Japanese kamikaze attacks and remembers his ship being hit by torpedoes, and being greeted only by seawater, not ammunition, when he attempted to obey an order and reload.
Grenny, 80, and a World War II veteran himself, helps veterans facing PTSD with therapy that helps find ways to distract themselves from such memories.
“After World War II, we didn”t even have the term PTSD. They talked about battle fatigue; if a guy had battle fatigue and was really rocky and clear symptoms of severe mental illness, he would get attention at the hospital,” Grenny said.
Many veterans buried their PTSD with drugs or alcohol or by becoming workaholics.
“They found these ways to distract or keep themselves extra busy so they wouldn”t have to think about the war scenes. Then comes retirement and these memories come flooding back,” Grenny said.
In dozens of interviews this reporter has had with veterans over the decades, a persistent dichotomy has emerged. Veterans almost always detest war more than non-veterans. But they also vigorously support those willing to fight, even in wars they don”t support. They often get angry at both war and war protesters.
Grenny sees that conflict among the veterans he works with. He remembers that a group of Vietnam veterans he was working with was 12 to 1 against invading Iraq.
“They are typically against us attacking another country ? On the other hand, I don”t know any of the veterans who are happy about the people out there with anti-war signs.”
Grenny has never had a member of Veterans for Peace (who often carry anti-war signs) as a client. He did see members of the old group Vietnam Veterans Against the War.
He sees a fairly consistent divide between support for the warriors and questions about political motives for war.
“It is kind of ironic — they weren”t supportive of us going in there, but they are now 100 percent supportive of the men out there risking their lives,” he said.
Grenny says the shame of what happened to returning Vietnam veterans is not being repeated toward those coming back from another unpopular war.
“The whole attitude of our country is much different toward the men at risk,” he said. He relays a story of a plane load of people applauding young veterans coming home on leave.
“There is real respect for the guy who is willing to go and serve his country.”
During World War II, Grenny was posted at the Naval Air Station in San Diego. He was part of missions that flew along the Pacific Coast looking for submarines and a feared invasion force that never arrived.
“Then I went out to the Philippines. By the time I got there the war was over,” he said.
The GI Bill allowed him to get his master”s degree from the University of Washington, and then he got the doctorate.
People can get PTSD from a variety of traumatic events such as a traffic accident, sexual assault or a natural disaster.
In the years Grenny has worked with PTSD sufferers, he has seen a divide between those who have been in combat and those who have not.
“Combat veterans have a complex kind of PTSD that is often more difficult to treat,” he said.
“They have a hard time, especially when they have lost friends next to them. They tend to be more closed, as far as personal relationships go ? They develop a defense against getting too close, letting [their] feelings out. It has been trouble for a lot of these guys. I know Vietnam vets on their fourth or fifth marriage, because women can”t stand the distance.”
Another Fort Bragg veteran seen by Grenny served in Burma. That man flew the 95 missions into China back and forth carrying supplies to Chiang Kai-shek and Mao over the Himalayas.
One of that veteran”s terrifying memories is looking into empty valleys along the roof of the world while throwing out supplies to enable the planes to climb. The worst memories come from when the Japanese blew up his plane while it was landing in Burma and the man behind him was blown to bits, causing the Fort Bragg man lifelong physical and mental injuries.
“He went through a lot of stuff. He was still falling out of bed with bad dreams when I was working with him. He is somewhat improved today. We helped him get the benefits he is entitled to,” Grenny said
The case illustrates how the problem has been kept buried by society”s misunderstandings.
“This was 60 years later. He had never had any help of any kind in all that time,” Grenny said.
The families of many veterans never find out about combat experience until the veteran dies and medals are found hidden in a drawer.
“Most combat veterans don”t want to talk about it,” Grenny said. “I think there is an anxiety the memories will overwhelm them, if they bring them out. Even when you see two combat veterans talking, they are probably talking about everything under the sun but that. They may be talking about something funny that happened over there, but not what was traumatic, even to each other.”
Part of the problem is cultural. “We grew up with a saying, men don”t cry,” and there is a desire to control emotion and so that”s part of it.”
Grenny has seen only a few women in his practice. The death of the 90th female service member in Iraq was recorded in November.
“I”m not seeing the new ones now, so I haven”t had many women come in,” Grenny said.
Although times have changed, and women now are in combat zones, he thinks the dynamic that contributes to keeping everything inside is still there.
“I don”t think it is much different. Boys still aren”t encouraged to express their feelings,” said Grenny.
Grenny helps with counseling. Those who need medicines must see the psychiatrist at the Ukiah VA clinic or they go to Fort Miley in San Francisco.
Grenny didn”t record PTSD for the young Fort Bragg Marine, a very strong young man. He says it took many Vietnam veterans 30 to 35 years or more to finally get help with their PTSD.
“He is well enough that he has been promoted since I”ve seen him. He”s motivated to protect the troops he”s working with. He may make the military a career ? at some point he should seek treatment. He is going to need it,” Grenny said.
PTSD first came to public attention when Gen. George Patton slapped a man suffering from severe “battle fatigue” and called him a coward. Patton was reprimanded by General Dwight Eisenhower, who backed medical professionals who had diagnosed severe mental illness caused by combat trauma.
Recently, some right wing groups have emerged to deny PTSD, as the mounting cost of the disease has been reported. Grenny said the armed forces is way beyond such denials and strives to provide the help that is possible, not debate issues which have already been resolved.
The New England Journal of Medicine recently released a study of Marine and Army veterans, which found that service members were much more likely to end up in combat in Iraq than Afghanistan and even more likely to come home with mental illness.
Mental illness was found to be higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent).
Only 23 to 40 percent of service members suffering from apparent mental illness sought mental health care, the study found. Stigma was a major factor in service members not seeking mental health care.
“Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care,” the NEJM article stated.
In addition to mental illness, many veterans are suffering from traumatic brain injuries, which can also cause a lifelong disability, the Army Times reported.
A mandatory VA screening program that took effect in April has looked at 61,285 veterans of the wars. Of those, 19.2 percent were identified on the screening questionnaire as potentially suffering from traumatic brain injuries and were referred for more tests. About 6 percent of those so far have been diagnosed with confirmed traumatic brain injury (TBI).
The Defense and Veterans Brain Injury Center, a joint Pentagon-VA research effort, found that 14 to 20 percent of troops in previous conflicts have had traumatic brain injuries. The center says there are reasons to expect a higher percentage among troops in the current conflicts because improved body armor has made them more likely to survive injuries that would have been fatal in previous wars, and because of the prevalence of roadside bombs and rocket-propelled grenades to attack U.S. forces. The blasts from such weapons can easily cause concussive brain injuries.
Sen. Daniel Akaka, D-Hawaii, chair of the Senate Veterans Affairs Committee, said it is clear that traumatic brain injury will be a major issue facing the VA in the future, the Army Times reported.
“Traumatic brain injury is the signature wound for veterans of the wars in Iraq and Afghanistan,” Akaka said. “I commend the Department of Veterans Affairs for stepping up their TBI screening for service members who have returned from combat.”
