The current rate of suicide among soldiers should make us angry, maybe enough to destroy our computers or, heaven forbid, write to congress or even try to stop war.

I checked out this institution¸ the National Center for Veterans Studies, the best I could. I am not sure why the Department of Defense and the Department of the Air Force seem to have a love affair with this division of the University of Utah.

Of their current projects, some of the proposed studies are randomized clinical trials of various therapies as suicide preventives. I am a great believer in research. But there is one question I am asked frequently, still, although I evaluate research but am not currently engaged in it. People ask me if I am a doctor first or a researcher first. There is absolutely no contest. I am a doctor first. I want lives saved, first.

If there is any real proof that any of the interventions they are talking about are actually helpful in saving lives, then it would be downright criminal to withhold such interventions from anyone. They say this is being reviewed by an “investigational review board.” One can only wonder which one. Probably several.

Since the grants are probably pretty large, the University of Utah has a vested interest in endorsing the studies. The federal government; well, they are not going to avoid endorsing their own grants. Nobody wants to look stupid, and the federal government surely does not. There is at least one factor cited in the article linked above that suggests a true factor here, in the increased suicidal rate, as compared to earlier wars. Isolation. I was on active duty in the post Vietnam era. Within military psychiatry, it was generally acknowledged that the problem with Army folks was people getting individual dates of service and individual times to come home as a function of their day of induction. This, it was said, destroyed the sense of cohesiveness of a unit. It was well known even before that era that a soldier in combat would fight for his “buddy,” for people on the front lines rarely mention ideals like “democracy.” The person in this story talks about soldiers living alone in apartments with their own televisions. When I was in the military in the late 80s, I was told that things were easier for the 18 year olds when they were all in barracks with a father-like non-commissioned officer (“Sarge”) in place of parents, telling them all to write letters home.

There was still some of this in the post-Vietnam era and everyone who had been around longer than me agreed it was healthy and good. Me, it made me smile to remind me of Sergeant Bilko and the gang on “The Phil Rivers TV Show”, which admittedly had a surrogate-family feel. If we have really lost that to kids in their own apartments with televisions, this is likely a hunk of the problem.

The impact of isolation in suicide risk is well known. It is constantly being cited as a risk in special populations; like Asperger’s, and those who live rurally, and even veterans.

People in research settings need to learn only things we really need to know, and things that will save lives.

Student veterans got problems; this should not be surprising. Like lots of studies, we ought not to avoid common sense when we look at what is going on with veterans. Let’s see, it is upsetting if naïve college students — probably Mormon; this is Utah — ask a returning veteran if he or she killed anybody? Remember, basically, that being in the military means learning how to kill effectively without getting killed yourself. Repeat this a couple hundred times and I can see suicidal thoughts over anybody’s horizon.

A study on academic predictors of success for student veterans is apparently being supervised by a research fellow who hasn’t got funding, so you could help him or maybe the nation by doing his questionnaire, without worrying too much about fattening up his fragile fellow’s salary. Any vet student who wants to do this could sign up.

A Pentagon-funded study claims to have the first scientific proof that these folks tried to kill themselves because of “intense psychological suffering and pain.” I am distinctly unimpressed by this finding. I think any third year medical student could have figured out that anyone who wanted to kill themselves had a pretty damned painful life — psychologically or physically — if death looked better. Our tax dollars hard at work.

Have you noticed how everyone cited, from the first article at the top of this missive, speaks of an increase in suicide rate? Everyone seems to be avoiding the current rate, the number of which invokes anger.

The director of this center at the University of Utah is an Army psychologist. A psychologist, not a psychiatrist; their work with the APA is from the “other” APA, American Psychological Association as opposed to American Psychiatric Association. I have always thought they were given to questionnaire type studies, and to working with each other as opposed to working with psychiatrists.

M.D. type folks like me really do have a special handle on physiology. People do not have protective covering on their neurons – brain cells – until around age 28. We are sending 18 and 19 year olds into battle. I want EEG and MRI and brain mapping and maybe even some natural substance treatment, but there are very few psychologists who will even treat in that pasture.

I will admit to an overwhelming bias concerning Army psychology; it can only have gotten better since I was in. Most of the real psychological work was done by “psych techs,” a credential not recognized in most states, although it is in California. Some call them 90 day wonders.

The only PhD psychologist I got to know a little locked himself in his office one day a week to give himself the Minnesota Multiphasic Personality Test (MMPI). It should not be used that way, and I took this as an indication of his own instability.

Most active duty psychologists known to me went ahead and had careers in the Department of Veterans Affairs. Me; been there, tried that, moved on. I cannot pretend to understand the politics of federal funding, or any kind of funding. For the time being at least, I live by the sweat of my own brow, calling them as I see them. In, for example, PTSD, there is an increased demand for treatment that will need to be met, admittedly at least somewhat, by psychological studies. The questioned should be asked about why the veteran combatants in this war feel more “intense psychological distress” than those who historically took part in other wars. We can and should be looking at the changes in neurotransmitters in these poor dear 18 year olds who are probably still crying for their mothers. We can and will find non-patentable drugs to treat them cheaply. As for psychological methods to save potential military suicide victims, it may just be wrong to assume that a cookie cutter psychological intervention like “cognitive therapy” can help.

Cognitive therapy is cheap and reproducible and can be done by “90 day wonders” trained by the military. Even if training is more detailed and advanced, people are wrong in thinking that it is the best or most lifesaving intervention. I have treated some career soldiers who love classes and instruction and “lockstep progressions” because that is how military life goes. I continue to believe that the strongest force in the world is the force of belief. Someone who believes in these methods can get better with cognitive therapy. Other methods are better for other folks. The projects that the group has written are easy projects for a psychologist to do, but I’m not sure they’ll solve problems and save lives. We need to look beyond the parochial divisions of specialties or education that universities perpetuate.

The best people to treat returning veterans are families. They care and they are free of charge to a growing government and cumbersome academic bureaucracy that purport to represent that government. The methods are simple and teachable.

I have “cured” PTSD in veterans in one or two sessions. I have offered to do it in front of cameras. I know it works, as do the patients I have treated with it. My model is basically a variation of Emotional Freedom Technique. Multiple times, I have offered my services to various veterans’ groups. They do not want “unproven” therapies, but want what they think works, which includes re-traumatizing veterans at every treatment session.

No, I don’t offer. I have started my own private practice, away from universities and bureaucracies. I did it once before, and it worked great. I have worked in a variety of settings, and I am applying this experience to my own private practice again. I will use all I know to help folks. My voice is unfettered; freedom of speech is mine, and I do the best I can to speak truth. And treat truth, with truth.

Author's Bio: 

Estelle Toby Goldstein, MD is a board-certified psychiatrist in private practice in San Diego, CA.

Practicing Medicine Since 1981

In her medical career, she has studied in Europe and Canada as well as the USA. She has attended specialty training beyond medical school in the fields of general surgery, neurology and neurosurgery and psychiatry (specializing in psychopharmacology).

Experienced In Many Situations

She has worked in a variety of positions, including:
◾Medical school professor
◾General and Orthopedic surgeon
◾Brain surgeon
◾Army Medical Corps psychiatrist
◾Prison psychiatrist
◾Community Mental Health Center staff
◾Consultant to a major transplant hospital
◾Drug researcher

“Whatever It Takes!”

She currently has her own indepenent clinic in San Diego where she is concentrating on what she calls Mind/Body medicine — or Integrative Medicine. Her practice is cash-only, doesn’t accept insurance or government payments, and she operates on the concierge, or “private doctor” practice model to give her patients the absolute best quality of care and the highest level of confidentiality.

Dr. Goldstein’s philosophy is “Whatever It Takes!” Her goal is to do everything possible to solve whatever problem she is presented. This includes seeing patients as quickly as possible — not making them wait weeks for an appointment. This includes making appointments days, nights, weekends or holidays. This includes making house-calls. And it includes using the best, most innovative treatments available — most of which are unknown to standard, mainstream doctors.

Her focus is on transitioning patients away from prescription drugs and onto natural substances. She is also a master practitioner of Emotional Freedom Technique, a powerful and dynamic form of energy psychology that usually brings quicker results than traditional psychotherapy.