Each week, veterans — many with minds upended by both seen and unseen battle scars — enter Dr. Walter Knake’s Beachwood office.
A welcoming flame glows from an electric fireplace. An Oriental rug blankets the floor. Propped everywhere are stuffed animals. The vibe is cozy and soothing. Except for the American and military flags in a corner and a large bulletin board packed with medals, patriotic badges and pins, the clinical psychologist’s office could be the den in a suburban home.
Each Nov. 11, Americans honor military veterans. Knake treats the ones who rarely feel honored or respected; much of their energy is consumed by the psychological effects of their military service.
Post-traumatic stress disorder (PTSD) is one issue. Others may be dealing with traumatic brain injuries or relationship issues, alcoholism, drug addiction or a combination of problems. About 70 percent of Knake’s patients are combat veterans who hear about his practice through word of mouth.
An average of 22 veterans commit suicide each day, according to statistics from the U.S. Department of Veterans Affairs. Aging veterans are the most vulnerable; 65 percent who died from suicide were 50 or older. Veterans made up 18 percent of all suicide deaths, according to most recently available statistics, but comprised just 8.5 percent of the county’s population.
Battlefield trauma and its long-term emotional consequences aren’t new. From the time people have fought wars, many carried the effects into middle and old age. Today’s PTSD was yesterday’s battle fatigue, shell shock or war neuroses.
As America continues losing its World War II and Korean War veterans, those who served in Vietnam are filling Knake’s appointment book. When people approach their 60s and 70s, most become increasingly reflective and have more time to think. For veterans, their thoughts often turn to their war experiences, he says.
“World War II vets came back as heroes and got a good reception. With Korean War vets, (the reception) wasn’t real positive or negative. Vietnam vets were judged. They were shamed and shunned. (People) thought they were women and child killers,” Knake says.
MORE HELP NEEDED
While many medical professionals, including those at the Veterans Administration, have gotten better at recognizing and treating the psychological effects of war on soldiers, more needs to be done, Knake says.
Talk therapy, rather than additional medication, is a good start. Veterans haunted by their war experiences “need to grieve and to express their frustration. The night is very difficult for Vietnam vets because the Viet Cong ruled the night. So they check doors, windows — they are hypervigilant after dark. Trust is a major issue. You have to teach individuals working with veterans to … try to understand and don’t judge. Don’t be frightened by them,” Knake adds.
While Vietnam veterans are seeking treatment today, Knake predicts a surge in those seeking psychological treatment when today’s combat soldiers approach middle- and later-age. The impact of multiple deployments — common in today’s volunteer force — is yet to be fully understood.
“When people who have been tremendously hurt by the actions, words of others — including surviving war, sexual, physical, verbal abuse in their childhood or adult traumatic experiences — rebuilding trust is a necessary goal in any communication with another human being,” he says. “It is vitally important that the person not be judged. Judgment by someone who has not walked a mile in their shoes will only lead to the further victimization and isolation,” and possibly to suicide.
For those outside the medical field, veteran support is largely a common sense issue. To start, if you learn someone is a veteran, thank them for their service. A genuine expression of gratitude usually will be well received, Knake advises.
Another tip: Honor their service by listening. Follow their cue and ask questions if you sense they want to talk.
A good way to begin is to suggest a time frame for the conversation. Mention that you have 10 or 15 minutes (or however long you wish) and would like to hear about their experiences in the military. “How was it for you, and how is it for you today?” is way to start a conversation, Knake says.
Not every veteran suffers psychologically from military service. Each one has a story to tell.
“Traumatic events separate your brain from your heart and soul,” Knake says. “What people who are traumatized need is a reconnection to themselves and a reconnection with other people.”