Welcome to the Leviathan of Institutions profiting from Stress Disorder, Junk Science, While Increasing rate of Suicides

David M. Boje, Ph.D. January 1, 2014; Revised April 9, 2014

Pharmaceutical industry and psychiatry have actually implemented Post Traumatic Stress medication treatments into a permanent Disorder-pathology that actually increased, rather than decreased the numbers of military (& civilian) suicides since 2002.

 

My sense is the living story is an aliveness that is being overshadowed, crowded out of awareness-domination of the grand narratives of macho-soldier, medication-only path to health, tough it out and never seek help, and the permanent Lifetime Disorder Label (PTSD) as Professor Gerald W. Vest calls it. The restorying process is a super powerful approach to healing when combined with the Psychocalisthenics exercises Gerry Vest and/or the Vipassana meditation that Febna Caven is doing here in Las Cruces, New Mexico.

As an organizational scholar, I am sensitized to the ways the pharmaceutical industry is profiting form the Life Time Disorder Label, PTSD. Somehow US society, its medical establishment has bought into the name game, naming post-deployment stress a Disorder. Millions of dollars are spent by the government funders on university research that is making matters worse. 22 veteran suicides a day, which is 8030 a year, and 56,210 in seven years, which is more than we lost in combat during that period. What is most relevant to organizational scholars, is the rate of suicide is increasing, and one possible reason is the medication approach, the labeling stress, anxiety, a Life Time Disorder is making it all profitable for the meds industry, but a tragic loss of life to the world. A related critical organizational assessment concerns the junk science associated with the Diagnostic and Statistical Manual of Mental Disorders (DSM). There are scores of empirical studies challenging the validity and reliability of the DSM PTSD, PSD, and anxiety protocols. Yet, they continue to be in widespread use in hospitals, VA, the military at large. The problem is a Leviathan of institutions that are increasing rates of suicides, and then blaming the victims of these meds, and DSM industries.

Eduardo Duran (2006) in Healing the Soul Wound gives some important insights into what I am calling 'Embodied Restorying Process.' The DSMs pathologize people with their Grand Narratives. A restorying cut off from Others and Ecosystem is disembodied, a social constructivist approach, a Cartesian Cut of Selves from (body) Awareness, from Others, from Ecosystem. By getting Awarenes sof our own Living Story Web of relaitons to Others, to Self in Ecosystems we gain understanding, we Wake Up --- See more on this point.

EMBODIED RESTORYING PROCESS (ERP) for Sustainability & De-Stress

ERP is a way to connect the body to the environment (Ecosystem+Others), in ways that promotes stress reduction. We live and work in cultures that are artificial, disconnecting our body from the rhythms of the Natural world. Our body was made to be in balance with nature, not to be in clocktime, or confined in virtual spaces, with simulated contact.

Getting family support is the quickest way for a veteran to find their 'new story.' Being labeled with a syndrome, disorder, a disability -- that is the quickest way for our veterans to get stuck in the 'old war story' for a very long time. I propose an embodied-restorying-process approach, one rooted in 'new materialisms' ways of understanding the relation of storytelling to embodiments of stress. Stressors are material, agential, inherent in military deployment, combat, and redeployment cycles.

“Since Sept. 11, 2001, more than 2.5 million American service members have been deployed to Iraq and Afghanistan” (VA, 2013a). Military service exposes personnel to material conditions called ‘stressors’ (ibid): “stressors, including risk to life, exposure to death, injury, sustained threat of injury, and the day-to-day family stress inherent in all phases of the military life cycle.”

Clearly there is a Federal mandate to help veterans cope with stress. Institutions, such as the U.S. Department of Veterans Affairs (VA, 2010) have implemented new rules regarding what constitutes stress: “This nation has a solemn obligation to the men and women who have honorably served this country and suffer from the often devastating emotional wounds of war,” said Secretary of Veterans Affairs Eric K. Shinseki.  

I will assert in this essay that there is so confounded an understanding of what is stress, in military, and popular culture, and that reporting stress by a soldier is tantamount to ending their career. There is a need to get more rigorous in our research about the relationship between story and stress (Eisenhardt, 1991).

There is an alternative. Begin to use ERP analysis as a method to reclaim 'story' from the psychologist reduction of the veteran's embodied living story to disembodied 'memory.' Embodied-Restorying resists reducing storytelling to language, to speech acts, or story-grammar. This resistance by restorying has implications for a new treatment of stress of deployment and redeployment of veterans. In the treatment of stress in the military veteran, the dominant mode of treatment is 'reliving the memory' of a stressor, a traumatic event, or desensitizing the memory by immersion therapy (aka prolonged exposure therapy, e.g. Foa & Rothbaum, 2007; Rothbaum, 2009). McLay, Wood, Webb-Murphy, Spira, Wiederhold, Pyne (2011), and Wood, Wiederhold, Spira (2010) are among a growing number of institutions offering virtual reality-graded exposure therapy for stress disorder in active duty service members with combat-related post-traumatic stress disorder. Here veterans experience a surround sound, aroma, visual, taste sensoriums of the trauma. Neuner, Schauer, Klaschik, Karunakara, and Elbert. (2004) use what is called 'narrative exposure therapy' to relive the trauma, in successive increments. It is combined with support counseling and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Or stress control using a variety of pharmaceuticals.

ERP can, at your option, be combined with a spiritual, soul healing appraoch.

SESSION ONE: RECHARACTERIZE AND EXTERNALIZE THE PROBLEM AS THE PROBLEM. We begin with stories of the veteran at their best. Then we name the problem as the problem, externalizing it from the person. For example, we name ‘Mr Stress’ or (Spirit of Stress) as the problem that has gripped the veteran. Here it is important to deconstruct the ways society, medical establishment, the media (movies, TV, news), and even the military are characterizing, making the person into a pathology, simulacra, a stigma, a stereotype. When a person is pathologized, they become the problem to be fixed by meds or treatments, or just shunned. The the systemic is the problem, then it frees veteran up, to empower-themselves to act, to change perceptions, to recharacterize and externalize. In short, I try not to pathologies, to approach veteran unconditionally.

SESSION TWO: BENEFITS AND COSTS OF Mr. STRESS (or SPIRIT OF STRESS). The problem has a grip because it somehow benefits (in weird ways) the veteran, and at same time it costs the veteran. Mr. Stress benefits by being an excuse, by giving license to venting, by being sources for meds, etc. Mr. Stress costs by its harm to relationships, making love conditional, making future of Heart-Self questionable, etc. These are important steps because they further deconstruct the ways the pathologizing is a blaming of the victim. In Soul Loss, for example, the Mr. Stress is intergenerational, a loss of soul due to Mr. Stress (Spirit of Stress), so there is less energy for love, peace, joy, gentleness, kindness, goodness, perseverance, and self-control.

SESSION THREE: RECOVER LITTLE WOW MOMENTS TO RESTORY. The Little Wow Moments (LWMs) continue form Session One. They are from before the Mr. Stress, they can even be intergenerational-before. The recovery of LWMs is crucial, as these are moments when there is resistance to Mr. Stress (Erving Goffman calls them unique outcomes). LWMs are fleeting moments when the tide seemed to turn, just a little. They are exceptions to the characterization, to the grand narrative expectations of society, media (movie stereotypes), medical models of pathology, etc. By recovering LWMs restorying becomes possible, and this is when we GO BACK TO THE FUTURE. Going back to the future, we take LWMs with us to create a totally ’new story’ of veteran and family. Another way to say it is there is soul recovery, so that the spirit is made whole. The intruding Mr. Stress spirit is sent on his way (in Shamanic Drumming terms).

SESSION FOUR: PUBLICIZE AND SUPPORT SYSTEMS. In this final session, the supporting people around the veterans and veteran has an hour to write letters to each other about ways to support the “new story” of veteran and of the family unit. Letters are also written to others in their community (friends and relatives) asking them to support the ’new story.’ As a facilitator, I come to the session with my letter to each support member, in support of ’new story’ practices. For example, it is important to not feed the old dominant narrative (the stigma, the pathology, the stereotype of flashback veteran,homeless veteran, etc.). If there is no support system, there will be total relapse, and collapse of ’new story’ beck into old grand narrative, old problem narrative. Without intervention, the surrounding system to the family will expect old ways, and demand them, because they are so very familiar.

ERP analysis is opposed to 'reliving the old story' on the couch, in groups, or in cyber-virtual reenactments. Reliving the old story is the problem, not the solution. Embodied-Restorying analysis seeks the 'new story' the 'liberating story' being told by the body. The psychologist seeks to liberate the 'old memory' by reliving its trauma. The psychologist seeks a 'label' that becomes a 'stigma' a 'disorder' a 'syndrome' of the mind, a 'classification' found in the 'Diagnostic and Statistical Manual of Mental Disorders' (DSM). Once labeled, the veteran may be eligible for benefits, however, there is also a scarring, a stigmatism, and separating of the DSM veteran from other veterans. Once labeled, in even the new DSM-V (2013; Spitze., First, & Wakefield, 2007) it is not so easy to get un-labeled, de-labeled, or re-labeled.

In the following review, I will make the case that stress is related to not just any kind of storytelling, but one that is embodied in institutions. There is an industry, an economy of public and private, institutions, including universities collaborate (coalesce) to prevent, diagnose, and treat the materializations of stress and stressors.

Literature Review

Embodied Restorying Process (ERP)is an alternative methodology for the treatment of stress of deployment, redeployment, separation, and career transitions to civilian life, sometimes to university life (Boje, 2013; Boje, Rosile, Hacker, England Kennedy, & Flora, 2013). Our literature review suggests restorying may well be an untried alternative to conventional ways of dealing with stress in the military.

Deployment: Restorying is an untried way to address attrition in treatment services during and after deployment. Students of deployment services question their efficacy (Hoge, Auchterlonie, & Milliken, 2006; Hoge, Terhakopian, Castro, et al., 2007). For example, there are explicit and implicit barriers to care in deployment and redeployment, as well as transitioning out of the military (Hoge, Castro, Messer, et al., 2004). Bowser (2010) asserts that treatment for stress comes too late for many veterans.

Labeling has its consequences on veterans: Brewin (2003) says that much of the labeling of veterans with stress disorder, stems more from myth and stereotype, rather than scientific evidence. Lembcke (2013) argues that military stress is so expected, in the movies, in news and magazine articles, and so forth, that it is now risen to the level of a cultural trope. Soldiers are expected to return home with war stories about flashbacks, nightmares, waking dreams of the dead. “Many barriers keep people with stress from seeking the help they need,” said Dr. Matthew Friedman, Executive Director of VA’s National Center for PTSD (VA, 2013b).

Enter the new materialists: The ‘new materialisms’ included in this review contribute a material-->discursive understanding of embodied-stress, the body situated in a wider causal field called the Leviathan of institutions (Boje, 2013). Leviathan of Thomas Hobbes (1651) is a forgotten materialism according to Samantha Frost (2010), Strand (2012, and in press), Jackson and Youngblood (2012), and Boje and Henderson (in press).

My new materialism proposition is that military stress has its Leviathan ways of materializing, so that stress takes on ‘aliveness’ a ‘self-organizing’ ‘living story,’ a career path in the military, of its own, materially and discursively, in a network of institutions: insurance, medical treatment, deployment command units, etc. (Boje, 2013). Matter in Western culture has been viewed as “devoid of agency” a mere collection of things instead of a “lively materiality” that is “self-transformative: and already “saturated with the agentic capacities and existential significance that are typically found in a separate, ideal, and subjectivist, realm”(Coole, 2010: 92).

Veterans' bodies are moving, spatializing and temporalizing within the wild being of the military, and that “introduces patterns, intervals, duration, and affects into Cartesian or Euclidian space from within it, and it continuously reconfigures its own corporeal schema in responding to and recomposing its milieu.

New Materialism, a new field of study, is a wider more inclusive causal field than either conventional stress treatment in the military, which too often blames the victim, the veteran as singularly responsible, as labeled the cause of their own stress, a disorder of their mind. Barad (2003, 2007) develops the theory of 'agential cut.' Following Barad (2003: 815) agential cuts enact “inherent ontological indeterminacy” and “agential separability.” Each institution has different narrative frameworks of the roles, plot, and career phases (agential cuts) of veterans experiencing stress. Each framing of stress is agential because the ‘agential cuts’ not only frame the sources, causes, and individual efficacy of PTSD, the way of framing is agential, a ‘cut’ of what is object and subject, antecedent and consequence, into a virtual career of stress, its stages, its role relationships, and its emplotment into beginning, middle, and end. For example, Coole and Frost (2010), Cook (2006) are challenging ways social constructivists leave out the body, the materiality of bodies, consumerist understanding of bodies, the agency of bodies. Edkins (2003) raises the possibility that there is politics involved in ways veterans get diagnosed with stress labels. Ehrenreich (2003) questions the social policy of this labeling. Others say the rise in other populations outside of women experiencing bodily or mental abuse, and veterans returning from combat, its expansion into every kind of situation from a car accident, cancer diagnosis, the death of a grandparent, failing an entrance exam to law school, going to prison, and even foreclosures from downward spirals in global capitalism -- is cause to be suspicious of the stress label (Siddiqui, 2009; Elbogen, Johnson, Newton, Straits-Troster, Vasterling, Wagner, &  Beckham, 2012).

Deconstructing Stress There is a growing number of articles deconstructing stress measurement methods, diagnostic protocol, and treatment approaches (Kerig, et al., 2012; Kerig, 2011; Maier, 2006; Flochman, 2004; Smid, 2011; Andres, Slade & Issakidis, 2002; Speigel, 2001). Folchman (2004) deconstructs the sociopolitical response to violence against women. Smid's (2011) thesis establishes the prevalence of delayed stress using a meta-analysis of disaster survivors.  Delayed stress did not decrease between 9 and 25 months after the traumatic event.  Andrews, Slade, and Issakidis (2002) deconstruct the singularity of PTSD by revealing its association to depression, compulsive obsession disorder, and anxiety disorders Rumyantseva & Stepanov, 2008). Maier (2006) deconstructs PTSD’s A-criterion. Bracken (1998) deconstructs PTSD, as having hidden institutional agendas. Pine less et al. (2009) deconstructs how PTSD shows attentional biases. The majority of the studies use methods unsuited for differentiating disengaging-attention from threatening stimuli (interference). Spiegel (2001) deconstructs PTSD as often only be known by the self-reports of the patients, as opposed to observable phenomena such as blood pressure, heart rate.  Beckman, Feldman, and Kirby (1998) deconstruct how PTSD is confounded with the materiality of atrocities, the severity of guilt and hindsight responsibility for wrongdoing during combat, such as committing violence toward others. 

Is stress a narrative or embodied, or both? There is growing evident stress is connected to narrative (Boje, 2013). "The connection between event and symptom, in this clinical narrative, is carried by a particular form of memory, the traumatic memory, in which the traces of the event resist the flow of biographical time, breaking through the past into the present" (citing Young, 1995; in De Jong, 2005: 363). One example, prominent in the military is called the The Warrior Myth (Archer, 2013: 7):

“A … rhetorical obstacle concerns how historical, cultural discourses about the bodies and minds of military service members impede better understanding of PTSD. Politicians, the Pentagon, and mainstream media venerate today’s U.S. soldiers with a consistency and intensity that has all but established the warrior as the ideal U.S. citizen.”

Trauma memories and experience are often treated as merely "pre-narrative," not fully formed into a coherent narratives of the trauma experiences by the veteran returning from combat zones (Mollica, 1988; van der Kolk & van der Hart, 1991).  

Stress seems correlated with Depression, and other domains: Wakefield and Horwitz (2007) assert that the business of stress and depression, its diagnostic instruments, its pharmaceuticals, the insurance claims --- has mushroomed into an industry Can we trust the medical protocols (McNally, 2009; Rosen & Frueh, 2010; DSM V, 2013)? If stress disorder, as Shepard (2004) says everything from 'surviving Auschwitz and that of being told rude jokes at work, is not the whole stress construct suspicious to begin with?

Stress can be gendered - Gross and Graham-Bermann (2006) assert that studies have not sufficiently control for gender differences.

Stress could be a culture-bound, not a universal construct: Now stress has become a "prominent cultural model" with a synergy between suffering and human rights, political advocacy, and traumatic stress advocacy (Breslau, 2004, De Jong, 2005).

In sum, stress in general, and PTSD in particular is a cultural narrative, and it is something embodied, perhaps it is both.

1) Stress inhabits living bodies in material ways (biochemical, phsicio-biologic, psychic-memory-neurology).
2) Stress is embodied in the Leviathan of military, State, University, Medicine, and other institutions (family, academic, clinical, pharmaceutical, neuroscience, etc.) all co-producing stress in veteran bodies in relation to other bodies with and without the syndrome of stress. This is my reading of Samantha Frost who develops a new materialism reading of Thomas Hobbes’ (1651) Leviathan.
3) Stress is embodied in the habit and disciplinary material/knowledge practices of military industrial complex, and formations of late modern capitalism where stress is recast as agentic singularity of veteran’s errant memory work.  This is a Foucauldian reading of new materialism
4) Stress is materialized in ‘observing instruments’ and ‘observing apparatuses as well as in treatment protocols, the agential cuts of Cartesians and of vital materialisms (Deleuze, Merleau-Ponty, Barad, Bennett, etc.).
5) Stress embodies the human spirit that haunts veterans, families, the military, social sciences of diagnosis (instrument production & measurement), and clinical treatments. 

An Embodied-Restorying Process Alternative

White and Epston (1990) do have one of the better treatments for stress, for veteran and their family (see also White, Mulvey, Fox, & Choate, 2012). A. What I propose is to give it an upgrade, so it works with critical new materialisms.  White and Epston (1990) limit their narrative therapy approach what is known widely as social constructivism. It is a ‘text’ framework, where materiality is missing in action.

Restorying results in studies with Military Veterans: This is also known as 'back to the future' since the approach is to find fragments of exception to the dominant narrative, and go back to the future to develop a new story. Palgi and Ben-Ezra (2010), for example, report on the procedures for using narrative restorying treatment with a single case. We overcome the single case problem (Yin, 2001) by looking at six cases. We are expanding that to six cases, while adding the dimensions of social support, affective regulation, and self-efficacy. Farnsworth, Jacob, and Kenneth W. Sewell. (2010) discuss the implications of the case study done by Palgi and Ben-Ezra. Monson and Friedman (2006) discuss how restoring can be coupled to conventional cognitive therapy.

Clearly more than single case study research is needed to bear out the claim that restorying works better than the conventional method, immersion, reliving the trauma memory, to desensitize the veteran.

White and Epston begin their book by advocating a Michel Foucault approach to discourse, hover remove all connection to materiality. White and Epston subscribe to the linguistic turn, and end up with an approach to 'restorying' that is without corporeality, without attention to the body, its rhythms, and ways the body is put into stress, its rhythms out of balance.

The reduction by White of Foucault to constructivism, occurs when Gregory Bateson, is brought into establish the move from Newtonian physics in 'living systems” (p. 2), followed by Edward Bruner to establish the 'text analogy' of 'narrative' (p. 2). Edward Bruner (1986a: 153) focus is on 'narrative structure' related concepts 'metaphor or paradigm" how "narrative emphasizes order and sequence" while "story" is "both linear and instantaneous" (as cited by White, 1990: 3).

White develops a table of six frameworks (positivist physical science (machine, mechanics, hydraulics), quasi-organism (biological), serious game (game theory), living room drama (dramaturgy), rite of passage (ritual, and the one they White and Epston base their praxis in, behavioral text (the performance of oppressive, dominant story or narrative knowledge).  After playing with a couple of examples from the six frameworks, White settles for "the text analogy" framework (pp. 9-10). 

The old restorying process, is stages of moving from diagnosing dominant linear (beginning-middle-end) narrative plots, their exclusions of 'unique outcomes, that can be gathered to construct 'new story' is summarized as narrative means to therapeutic ends, a pragmatic way of reframing the text analogy.   White mentions Marxist class ways of framing "traumatic personal experiences" and "gender-specific repressive" ways of power, then returns to Michel Foucault's contribution to the "analysis of power", the "constitutive effects of power, and being "subject to power through normalizing 'truths" citing Foucault (1970, 1980, 1984a) (see White, p. 19). Power/knowledge is reduced to normalizing discourse, to text analogy, but the 'vehicles of power,' the materialisms, including the technologies of power, the discourse<---->material from Foucault all is left out, except the mention of "manuals" that "provided meticulous instruction not he correct methods for the supervision of childhood sexuality" (p. 21). 

There is something material in White and Epston (1990) old way of restorying, something to take forward in what I am proposing here.

Materiality of Writing - At the same time, what is ironic, is the restorying praxis, is all about material practices. For example, letter writing between therapist and family members, and family members to one another is a requisite practice of restorying, done in sessions or as homework, and communication in between sessions. It is the act of writing that transforms restorying from the alternative therapy practices of talk therapy. Writing introduces coherence, and exposition, in the written tradition to therapy (p. 35). 

I will propose a non-constructivst approach to restorying, I am calling Embodied-Restorying. It is important to give the veteran a target for their stress beyond the discorded mind: “If fear has no object, then no recursive movement around memory is possible, no simplification of causality can take place, and no anticipation of causality can take place, and no anticipating projection can occur” (Frost, 2010: 169).

Table 1 lists 7 steps to a new approach to Restorying, one situated existentially in space, in time, in the materiality and corporeality and agency of the body, its diverse rhythms.

The embodied-restorying analyst works through the seven steps of restorying to discover and uncover Little Wow Moments of Exception to the 'old story' about the veteran. The 7th step is family support, friend support, colleague support. It begins earlier than the 7th step. Without support the 'new story' atrophies and the 'old story' and the 'old labels' regain agency, their grip secure, harder to restory.

 

The restorying analyst calls the whole body the storyteller. The psychologist refers to the mind as the storyteller, relives the past 'memory.' The restorying analyst begins with taking that first step.

1. Recharacterize (authentic Self identity). Tell a story that is ideal – when you were at your best? Why tell a war story, a story the military psychologist, the VA, the popular culture (movies, newspapers, magazines) all expect the veteran to tell. Where is the 'authentic self'? Surely the authentic self of the veteran is not the story told by psychologists. Restorying assumes the problem is the problem. The person is not the problem. The way the veteran is characterized is the problem.

What's wrong with the Linguistic Turn?

Everything! It has dismissed the body, and treats it as linguistic rhetoric, such as a metaphor, simile, or just trope, and not at all corporeal. For those who still stay in the linguistic turn, storytelling is language, not a corporeal process of body. In the linguistic turn, storytelling is speech acts and the silent yet eloquent body language. For those who follow Bruno Latour, Karen Barad, or Henri Lefebvre, and many others, body is existential. The military body has a story to tell, and many institutions are telling stories about military bodies. The assemblage of bodies in deployment, redeployment, and transitions in and out of the military constitute a self-organizing assemblage of bodies. That self-organizing assemblage of bodies is agential. The assemblage of bodies is acting in spaces, in times, and there is a mattering of momentum as bodies move in deployment, redeployment, and transitions.

Excerpts from Boje (in press): “Polkinghorne (2004) has raised objections to restorying because it purports to build self-agency, whereas his own strictly social constructivist standpoint treats the ‘self’ as a linguistic social construction with nothing to do with space-time-materiality, since all of this is social construction. Polkinghorne (2007) is critical of a Foucauldian approach to power and knowledge (i.e., micro-physics), and instead bases his approach to narrative on epistemic, rooted in Kenneth Gergen’s social constructivism.

Polkinghorne, an unrepentant ‘social constructivist,’ says that White and Epston’s Restorying approach is an “existential view that people have a capacity to revise and reauthor the narratives in which they have been acculturated” (2003: 65). From his social constructivist standpoint, the social realm dominates the personal (existential) and the biological (material) realms. Polkinghorne takes the standpoint “that the meaning is essentially language” and “all human systems are linguistic systems” where “there is nothing outside of language” (2003: 58).

There is a second theme that comes through in Polkinghorne. Narrative displays a temporal dimension that unifies experience with a “beginning, middle, and end” dominant governing plot that is socially supplied (ibid.: 58). He agrees that many “unique outcomes” are left out by the dominant plot” (ibid.: 60) and that a “new and more complex plot” is what Restorying is after. Polkinghorne cites another prominent social constructivist (and postmodernist) who is well regarded in Appreciative Inquiry circles, Ken Gergen. Both Polkinghorne and Gergen treat personal and biological (including the body) realms as under the auspices of the constraints set by the social realm (ibid.: 61). It is the “social realm” that controls the body’s actions, imposing rhythms of work, rest, holidays, eating habits, and so on, and limits the possible activities the body can undertake (ibid.: 62). In sum, personal ‘self’ and ‘materiality’ from a constructivist standpoint are only a linguistic category, part of language socialization.
The American Pragmatist George Herbert Mead (1932) has a very different temporality conception than that of social constructivists such as Polkinghorne (1988; 2004) and Gergen (1994). For Mead, time is conceived as a passage in league with space and energy, where out of emergences noticed in the present, past experiences are selectively engaged in order to promote expected future courses of action. Mead’s (1932) is an ontological and a quantum approach, as is the work of John Dewey (1929).
END QUOTE FROM BOJE’s (in press) new book.

Embodied-Restorying Process Analysis Method

The ERP analyst calls the body an instrument of observation. The body is a bundle of rhythms. Lots of bodies together have self-organizing rhythms: marching, marathons, drill formations, lining up for chow. To understand the rhythms and moments of a self-organizing assemblage of military bodies, first understand one's own body. The analyst body is an instrument, itself an assemblage of rhythms: breathing in and out, blood pulses, heart beats, flow of speech tones, gestures of the limbs, movement of facial muscles, neck hair that stands up, a flush of the cheeks, a change in posture, a quickening of steps. The body is attuned to its environment: darkness and sunlight; cold and hot weather; the slope of landscape; the rush of the wind; the waves and currents of the ocean; the horizon. Awareness of the balance of the body's rhythms and when they go out of balance is a good way to get out of a pathological situation.

Eurhythmia for Henri Lefebvre is the rhythms of a body in balance, in harmony. Eurhythmia is what all that PT training, the classes, the R&R is trying to achieve, a healthy veteran body. Stress is when the body rhythms are disrupted, such as by sleepless nights, lack of nourishment, fear of engagement, and so forth. The body chemistry can get hooked on adrenalin, on the rush of stress.

Arrhythmic for Lefebvre is rhythms out of balance, not in harmony. Arrhythmic is an unbalance of body rhythms over many events. Arrhythmic is when the body rhythms do not return to balance. Run a marathon, the body recovers. Go skiing on an intermediate sloe, a skilled skier recovers their breathing, heart rate, body heat.

Polyrhythm - The body is a bundle of diverse, interacting rhythms, or polyrhythm. The many rhythms of the body self-organize to adapt to the environment, to stress, to demands made on the body.

The restorying analysis method is focused on the body, in its spaces, times, and materiality. To focus on the body, its rhythms is against the rules of psychology methods, which must confirm the diagnosis and protocol of treatment, as cognitive, behavioral, or just re-memory work. Restorying methodology views these elements in the context of the whole body, which has many more rhythms.

Family Support

The family is first line of support for the veteran to transform their 'old story' that 'war story' into a 'new story.' Without family support the old story finds its way back, becomes once again dominant. The family does not like change. Better the old story the family has come to expect, adapted its situation to. The new story is different, unexpected. "What's wrong with you?" Children are caught in the middle, between soldier and spouse. Social support (Turner, 1992) is critical to the success of restorying approaches to stress.

The military family is the second line of support (Mikulincer, Florian, & Solomon, 1995). It is widely agree that following deployment, families face the threat of marital stress, and dissolution (Riviere, Merrill, Thomas, Wilk, & Bliese, 2012). 2Marital intimacy, family support, and secondary traumatization: A study of wives . In deployment, the military becomes the primary family. Upon return, the veteran has to adapt, make their wife, children, parents, siblings, aunts, uncles, grandparents --- the primary, and the military family, the secondary line of support.

This reversal of relatives-family and military-family is where 'restorying' is most useful. The family of spouse and children do not know what to expect. The veteran has a military family. Its all quite different. Perhaps there is a redeployment or deployment training session, a couples seminar. That is an excellent place and time for restorying. There are military units dedicated to hosting Family Support meetings. The storytelling, however, can be that of psychologists who advise everyone to relive those stress events, relive the stress. A restorying analyst focuses on the body, on the storytelling body, on transitioning from old war stories to a new story of the future.

It is a mistake widely made in the military to limit orientations and treatments to reliving stress. What about restorying from old war stories to new stories of the future? Open the door to many futures.

Getting family support is the quickest way for a veteran to find their new story. Being labeled with a syndrome, disorder, a disability -- that is the quickest way to get stuck in the old story for a very long time.

While PTSD is widely deconstructed for its lack of theory, validity, and reliability, there is something else to deconstruct: how just the labeling of PTSD affect family relationships. Hawkins, Grossbard, Benbow, Nacev, and Kivlahan (2012) argue for a more evidence-based approach to stress diagnosis. If stress is more cultural narrative than it is evidence-based, embodiment of symptoms, this raises issues about the stigma of PTSD and other stress syndromes, disorders, etc. According to National Center for PTSD (2013), several recent studies have found that veterans' PTSD symptoms can negatively impact family relationships and that family relationships may exacerbate or ameliorate a veteran's PTSD, its material manifestations, and on or links to other stressor conditions.  PTSD studies show correlation to marital happiness. Research findings, to date, are that veterans with PTSD conditions are more likely to report marital or relationship problems have higher levels of parenting problems, and generally poorer family adjustment than Veterans without PTSD (Jordan, Marmar, Fairbank, Schlenger, Kulka, Hough et al., 1992; Mikulincer, Florian,  & Solomon, 1995; Riggs, Byrne, Weathers, & Litz, 1998). 

Stress may be more cultural than it is universal. PTSD is likely cultural. Expect it to go away and it does. Expect it forever and it complies. PTSD is already a Western cultural model for understanding and caring for suffering human beings. While it is a recognizable diagnostic (observing) apparatus in a variety of cultures, PTSD involves complicity with the promoters and sellers of PSTD instrumentalities (Boje, 2013).

Conclusions

By nature, stress is when the rhythms of the body are out of whack. The veteran looses sleep, gets tired, the energy is lower. Restorying is way to move out of the 'old war story' and find a 'new story' of possibility.

The tie in to critical new materialisms is in the first two chapters of White and Epston (1990).  Several works by Michel Foucault are summarized, but without the emphasis of Foucault's work in the critical new materialisms.  The result is Foucault from his power/knowledge, through discipline and punish, and the technology of the body --- gets reduced to a discursive approach to storytelling for family systems.  The critical new materialisms, by contrast, are about the mutual relationship of material<---->discursive. Actually, for Foucault the discursive<---->material is his priority.  

 

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We need to stop blaming the victims of traumatic events. We need to stop stigmatizing stress in and out of the military. The result of stigmatizing, and pathologizing stress into a permanent disorder, is no one is going for help. People are gaming the typical survey tests, and say anything to get out and get on with their leave. The tragedy is people game the system of assessment of stress, then would rather commit suicide than seek help for stress, and face the social stigma. There is also a stigma placed on troops returning from deplooyment. Many people retrun from deployment and are just fine. So much storytelling of veterans with stress, that universities and employers are highly sensitized by this media storytelling. It seems to me that those of us doing organizational storytelling, can draw attention to the commodification of stress, how it 'blames the victims' and is sold by the media outlests as a disorder by various institutions, from universities, pharmaceutical, to errant counselors, to neuroscience laboratories, and so on. There is a veritable Leviathan of institutions commodifying stress disorder. Meanwhile the ways of training in coping with stress, goes wanting. Can we use storytelling theory and methods to help veterans to reclaim an authentic self from Leviathan?

Introduction

Before deconstructing DSM, the complete scientific lack of validity of PTSD, and that ways Leviathan of pharaceutical industries profits from pathologizing PTSD into something meds, cognitive behavioral modification, and reliving a signular trauma event (aka desensitization), let's look at what is possible if we do what I call 'embodied restorying.' Embodied Restorying, combines a routine of breath and meditation exercies with restorying PTSD into what it is, a blame game used by media and phraceutical industries for enormous profits.

PART I: The Good News! There is an alternative to Blaming & Eploiting the Victim

Develop an understanding of the 'materiality of PTSD' pathologizing, and stigmatizing and how it manifests in a profitable pharmecetucial industry. Enough junk science (Rappoport, 2014):

" There are no defining physical tests for any of the 300 so-called mental disorders. All diagnoses are based on arbitrary clusters or menus of human behavior. The drugs are harmful, dangerous, toxic. Some of them induce violence. Suicide, homicide. Some of the drugs cause brain damage."

People are buying into the DSM claims: Stress is a reaction to both high-magnitude traumatic events and events of low-magnitude. High-magnitude traumatic events in the DMS-IV Diagnostic Criteria for PTSD:

1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others

2. The person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

Low-magnitude trauma events can also show all the symptoms of stess. This includes low-magnitide events such as: "nontraumatic deaths, serious illness, a spouse's affair, and repeated episodes of bullying, intimidation, or uncontrollable stress at work" and "victims of talking.... repeated harassing telephone calls, E-mails, letters, or other material; are constantly watched and followed; and have their homes broken into and their property damaged" (Brewin, 2003: 48).

Something important has happened to stess. It has morphed from the above DMS Medical pathology-category of diagnosis of reaction to trauma events, into a cultural expectation, a media trope. The result is people with authentic need for stress are mixed together with the new fashion, a social desirability to have a coming-home war-story of all the stress symptoms that one saw in the latest war movie, or TV news report. Click here

Stress has become a cultural identity-marker in post-empire America, aka, Leviathan.

Is it true that there are no alternatives to the pathologizing, the over-medication-for-profit?

At http://peaceaware.com I list a number of meditation approaches that do not involve medication or cognitive behavior mod, or reliving the so-called single trauma event.

"The more we develop this awareness the more illuminating and alive it becomes for us. Thoughts no longer distract us; we can remain open, clear and balanced. This penetrative, open quality is like the sunlight that shines forth in all directions. When we do not take positions, the door to enlightenment is completely open, and we understand quite naturally what is called "universal" mind, infinity, or genuine understanding" (Tibetan Meditation by Tarthang Tulku, p. 77)

PCALS - Psychocalisthenics® (PCals) can be done easily at home, needs little space and no equipment

Below, Integration Breath short intro is next

Below A few exercies demonstration; Declan Rothwell teacher showing and performing the art of Pcals

Below - a complete work out you can do at home

 

PART II: STRESS IS STORYTELLING GONE WILD, A GAME OF BLAMING THE VICTIM!.

TRUTH ABOUT PTSD RESEARCH AND THEORY

The pharmaceutical industry and psychiatry have actually implemented the PTSD med treatments in ways that have increased, rather than decreased the numbers of military (& civilian) suicides.

I think the major thing we are facing is how the narrative of stigma in American culture leads our service men and women into denial, so that they dare not avail themselves of even the most basic skill training courses, much less enter therapy. The ignorant stigmatization and pathologizing of stress by the mental health industry, the journalistic media, the university, etc.

NPR tape of the lack of validity and reliablity of the stress tests used before and after deployment.

Despite the many studies deconstructing the validity of PTSD measurements, including the sacred DSM categoreis, soldiers and the general public continue to be subjected to 'junk science.' The National Institute of Health, and its DSM protocol, says PTSD consists of three things:

1. Re-experiencing an event via flashbacks and nightmares

2. Avodidance via depressiong, guilt and staying away form certain places that are reminders

3. Hyperarousal resulting in insomnia, angry outbursts, and feeling always on the edge.

See for example Washtington Post.TV; PBS This Emotional Life 2010; University of Washington panel 2009 on meds and treatment options;

The proponents of PTSD argue that it affects 7.5 million americans. Further the advocates for a PTSD diagnosis assert that there are few alternative treatments to talk-therapy and of course, medications from the pharaceutical industry, administered forever to contain PTSD.

What is the result?

Post-Traumatic Stress becomes labeled a 'disorder,' a 'pathology' that has no effective treatment beyond cognitive behavior modification, reliving the singular trauma event, and of course medications from the pharaceutical industry.

We do a disservice to veterans, by inferring from paper and pencil tests of PTSD, with highly questionable validity, and a naive public takes the media storytelling hype as valid, in order to paint all veterans with one grand narrative of flashback, etc. is an even greater disservice.

Veterans are gaming the PTSD paper and pencil tests, in order to avoid the public stigma promoted by the media, and by propenents of PTSD as a pathology.

With the immense stigma against anything to do with therapy in the U.S. particularly among the military warriors, few people have the courage to apply for services, and most have to apply twice, and have to be tough enough to face the stigma. They take the route of self-endangerment, or outright suicide. How many marriages wrecked, how much anger passed along to children. What is the total cost of the way society stigmatizes caring for veterans and their families?

I think it is import to face these facts. People get their ideas of how to handle military combat stress from the movies. Is it accurate? The military relies on Hollywood cooperation, to access archives of warships and equipment, so that movies can shape popular culture. This is a long-standing propaganda narrative co-production. It manipulates the public’s viewpoint about how to cope with stress (Robb, 2004).

PART III: THE HIDDEN ENEMY

Welcome Home our Vets and Families with Health Services and Beware of "The Hidden Enemy"! "In early 2013, the official website of the United States Department of Defense announced the startling statistic that the number of military suicides in 2012 had far exceeded the total of those killed in battle – an average of nearly one a day. A month later came an even more sobering statistic from the U.S. Department of Veterans Affairs: veteran suicide was running at 22 a day – about 8000 a year" (source: The Hidden Enemy). Actually is 22 a day, which 8,030 a year, and in 7 years, that 56,210 each year.

SEE VIDEO - The Hidden Enemy

Summary - the military is being destroyed from within by a dangerous enemy,"the soaring rates of psychiatric drug prescribing since 2003"... "And in psychiatry, diagnoses of psychological disorders such as PTSD, personality disorder and social anxiety disorder are almost inevitably followed by the prescription of at least one psychiatric drug." What are the business implications, the capitalist complicity? "In the face of these grim military suicide statistics, more and more money is being lavished on psychiatry: the U.S. Pentagon now spends $2 billion a year on mental health alone. The Veterans Administration’s mental health budget has skyrocketed from less than $3 billion in 2007 to nearly $7 billion in 2014—all while conditions continue to worsen." In short, the US pharacetuical industry is drugging the military for profit. There is a psychiatric pop-a-pill “quick-fix” mentality being sold in the marketing.

 

PART IV: SUICIDE AND THE REAL ENEMY WITHIN

"From 2001 to 2009, the Army’s suicide rate increased more than 150% while orders for psychiatric drugs rose 76% over the same period. These soaring statistics cannot be attributed to the horrors of war, as 85% of military suicide victims had never even seen combat" ... "These chemical compounds, however, can produce harmful consequences, and accumulating evidence shows that the ever-increasing use of psychiatric drugs may be fueling an epidemic of military suicides and unexplained deaths." (CCHR.org).

As of April 8 2014 -- "Over 125 meetings with Congress, the VA, the Pentagon and the White House. We mobilized the community at our National Day of Action where we planted 1,892 American flags on the National Mall to represent the veterans we have lost to suicide just this year alone" Suicide Prevention for America’s Veterans (SAV) Act, a sweeping new IAVA-crafted bill aimed at combating suicide).

On the planet Earth there are one millions suicides a year. "In America, suicide rates are higher in less populated, less wealthy areas" (source).

In the US, 22 suicides a day are by veterans. Of the 22 about 1 of these is active duty, and others are young men and women one to three years after filing DD214. Do the math: 8030 veteran suicides a year. That is more veterans than died in combat in all the years of Iraq and Afghanistan. Something is wrong when more soldiers fall in suicide than in combat. "The number of young veterans committing suicide nationally spiked dramatically from 2009 to 2011" (Kuta, 2014: 1). Kuta goes on to report "Suicides among 18- to 29-year-old male veterans increased from 40.3 per 100,000 in 2009 to 57.9 per 100,000 in 2011. Among 18- to 24-year-olds, that rate increased by more than 70 percent, from 46.1 to 79.1 per 100,000 veterans" (ibid: 1). For some reason, 2012 was the deadliest suicide year on record for U.S. forces.

There is something wrong. In just one year, 8,030 veteran suicides is more than died in combat in Afghanistan war between 2001-2014. One year of veteran suicides is about double the Iraq war casualties between 2003 and 2011. The total war casualties of War on Terror is 50,897 between 2001 and 2014. That means at 8,030 veterans suicides a year, in 7 years, the number of suicides is 56,210, which is about how many soldiers died in combat in Vietnam, and is more than all the war dead since Vietnam

What does it mean? In civilian U.S. population more people now die of suicide than in car accidents. To me it means, that U.S. society is on the decline. According to Center for Disease Control and Prevention, in 2010 there were 33,687 deaths from motor vehicle crashes and 38,364 suicides (source). There were 38,364 suicides in 2010 in the United States--an average of 105 each day (source).

In sum, of 105 suicides a day in U.S., 22 are veterans, and one of these is active duty military.

PART V: What is stigma?

Stigma can be defined as negative stereotypes about seeking mental health help, social status loss in the military from being labeled with a stress disorder, and discrimination related to a particular perception of difference of a solder who is macho, and one needing help with stress, anger, depression, and so forth (Link & Phelan, 2001; Goffman, 1963; Hoge et al., 2004; Wahl, 1999). According to National Council on Disabilities, there are three kinds of stigma:

1. Public Stigma: public (mis)perceptions of individuals with mental illnesses. Soldiers do not want to be perceived as weak, or blamed for theeir problems. The public has a general fear of stress among the military, since Vietnam days.

2. Self Stigma: veteran internalizes the public stigma (such as from depictions of soldiers in movies) and does not want to feel weak, ashamed or embarrassed.

3. Structural Stigma: institutional policies or practices that unnecessarily restrict opportunities to veterans to achieve help and health. For example, going for help, at one time, meant a barrier to promotion; military leaders at one time would blame the soldier for not being tough enough to handle stress problems.

What is structural stigma? For example, 46% of employers in a 2010 survey by Society of Human Resorce Management said "PTSD or other mental health issues were challenges in hiring employees with military experience." Results of a 2011 survey of 831 39% of the hiring managers are "less favorable" toward hiring military personnel when considering war-related psychological disorders." (Health Today).

There is good news.  Soldiers, sailors, airmen, Marines, Coast Guard, Reserve, veterans and their family members, the military is changing. "Suicides across the military have dropped by more than 22 percent this year, defense officials said, amid an array of new programs targeting what the Defense Department calls an epidemic that took more service members' lives last year than the war in Afghanistan did during that same period... Each of the military services has seen the total go down this year, ranging from an 11 percent dip in the Marine Corps to a 28 percent drop for the Navy. The Air Force had a 21 percent decline, while Army totals fell by 24 percent" (Fox News 2013). The structural stigma is getting attention. They are on quest to really eliminate stigma of seeking help for stress. For example, during a visit to a Fort Bliss, Texas, treatment center designed to help troops with post-traumatic stress disorder, Secretary of Defense Robert Gates announced a policy change:

"The most important thing for us now is to get the word out, as far as we can, to every man and woman in uniform to let them know about this change, to let them know the efforts that are underway to remove the stigma, and to encourage them to seek help when they are in the theater or when they return from the theater" (PBS).

"Fearing for their careers, many service members keep quiet about their mental health problems—and their silent suffering is taking a toll on our military readiness. In response, the Defense Department has begun fighting stigma on several front" (Dingfelder, 2009: 52). For example, the "Defense Department recently revised its security clearance questionnaire so that people who seek mental health care for combat-related reasons do not have to report it" (ibid.: 52).  The military has a new anti-stigma campaign called "Real Warriors. Real Battles. Real Strength." Stress is a material condition. In Canada, it is openly discussed as toxic occupational, a material work-related hazard (PBS). Canada wants to remove the barrier for its veterans getting care.

The problems is despite the DOD efforts, in U.S. popular culture , the stigma about stress, or any mental health care, is still very strong.

What is relation of Stigma and Stress? Stress is a well-known contributor to suicide-risk. Most research, treatment, and intervention blames the victim of stress for any and all stress. What is missing in the research is eliminating the cultural stigma associated with stress. Without a coherent storytelling of the causes of the stess condition (without specific aetiology), the veteran can find no valid reason for it except the 'clinical syndrome' materialized in the test itself as a category or a dimension called stess, that veteran can only express stess in terms of storytelling the historical or mythical explanation, or spiritually, about being haunted by a memory. Ironically, the dominant therapy approach to stess treatment in the military and for veterans who have left it, is to relive the memory again and again, wild facing their fear, by going into situations that prompt the 'syndrome' in everyday life. Since stess overlaps with lots of other categories and/or dimensions such as depression, anxiety, etc., the veteran (and I would suspect their psychiatrist or psychologist) does not know what is being treated whatsoever.

What is relation between Stigma and the Movies about Stress?

There are blogs devoted to stess in Vietnam era war movies:

• Taxi Driver (1976)
• Coming Home (1978)
• Apocalypse Now (1979)
• The Deer Hunter (1979)
• Return of the Soldier (1982)
• Birdy (1984)
• Born on the Fourth of July (1989)
• Heaven and Earth (1993)

There is a website where you can rank order movies about stress in military, in secret service, etc. Click here to rank the movies. This site adds Patton and Taxi Driver to the list of movies about stressed out veterans.

What is going wrong with Traditional Stress Psychology? In my view,traditional stress psychology is doing harm to veterans and families. Why? Stress psychology continues to blame the victim within U.S. society that itself stereotypes veterans in the movies as damaged characters (Rambo, First Blood, Taxi Driver, Deer Hunter, Apocalypse Now, etc.). The cultural narrative (trope) has the expected plot element of the flashback by the veteran. The recommended cure by stress psychology is more flashback to desensitize the event-memory. Try getting a job after your recruiter watches Rambo or Deer Hunter?

Does traditional stress psychology wound warriors? Does this positive stress psychology movement help where traditional stress psychology has failed?

Both the old and the new stress psychology save lives. Does traditional stress psychology stereotype, label, stigmatize veterans? Is the new approach getting beyond the old stigma?

There are still soldiers unwilling to put ‘veteran’ on their employment application. There are still veterans not participating with either the old or the new stress psychology.

Here is a summary of my Top ten concerns:
1. Traditional stress psychologists deproblematize the material history of stress in U.S.A. Into a totalizing ‘grand narrative’ (Lyotard, 1979) and hence what I call a thousand ‘living stories’ of the lifeworld of veteran and family are backgrounded, marginalized, or dismissed as irrelevant to the psychology of stress.
2. Traditional stress psychologists use and authorize what Michel Foucault (Birth of the Clinic; Madness & Civilization; Technologies of Self; Discipline & Punish) calls ‘technologies of power’ to effect power and domination of one culture over many others in ways that is not ethically answerable for ethnocide, genocide, and proceeds to blame the victim.
3. Traditional stress psychology’s DSM categories legitimate the pharmaceutical companies to medicalize stress among veterans and their families.
4. Traditional stress psychology is a way of ‘science’ that objectifies veteran and family violence through practices of cultural domination and the systemic destruction of ethnic and Native family.
5. Traditional stress psychology lacks relevance to real-life material life world of veteran and family in spaces, times, and material conditions of the military, and U.S.A. Life worlds.
6. Traditional stress psychology banishes the spiritual, all things metaphysical, and any soul wounds to another pathological category, while pretending to study cultural differences.
7. Traditional stress psychology is a means by which white male categories of stress become that basis for understanding cross-cultural differences in stress and violence in schools, families, business, universities, and the military-industrial-pharmaseutical complex.
8. Traditional stress psychology colonizes ethnic, racial, and Native American identities with a ‘white’ subjectivity of stress diagnosis and treatment.
9. Traditional stress psychologists disempower veteran’s agency to be historical, cross-cultural, and spiritual.
10. Traditional stress psychology inflicts more wounds on warriors, and their families, with each category of diagnosis, intervention, and stigmatization of stereotyped identity work.

In sum traditional stress psychology is a danger to health because it continues a neocolonialism masquerading as ‘objective science’ with disastrous results.

Positive stress psychology also masquerades as objective, acultural, universalistic science. It does succeed in moving out of the duality of you have stress or you don’t, into a multi-dimensional approach that includes family, spirituality, animals, fitness, and so forth.

The veteran is forced by traditional stress psychologists to abandon ethnic and cross-cultural beliefs and adopt the Judeo-Crhistian worldview of stress. To what extent is the new approach to stress psychology more open to more kinds of spirituality, more cultures, more alternative healing approaches?
Once the traditional stress psychologists diagnoses and stereotypes a veteran and family with stress problems, that stress-identity is carried forward into civilian life, into university, into non-military careers. Is this the case for positive stress psychology?

There are cross-cultural differences, in suicides. 73% of all suicide deaths are white males.

U.S. Suicide Statistics (2001)source
Further Breakdown by Gender / Ethnicity
    Rate Per Group        # of Suicides   100,000

White Male.........22,328........19.5

White Female ........5,382.........4.6

Nonwhite Male ........2,344........9.3

Nonwhite Female ......568.........2.1

Black Male .............1,627.........9.2

Black Female.............330.........1.7

Hispanic.................1,850.........5.0

I come bearing gifts. I propose an alternative to traditional stress psychology. It is called ‘embodied restorying’ in support of veterans and their families. It is cross-cultural, it is ethnic, and Native, spiritual, involves horses (groundwork( and it problematizes the traditional stress psychology Cartesian ‘cut’ and ‘separation’ of subjectivity and objectivity. Rather, in embodied restorying, history, cross-culture, technologies of self, the hegemony of a science that tries to universalize stress as acultural, ahistorical, and proceeds to blame the victim — all that is ripe for deconstruction.

"With so much attention, understandably, on the disorder, few researchers have asked soldiers about positive changes they might have experienced” Source: http://www.nytimes.com/2012/03/25/magazine/post-traumatic-stresss-surprisingly-positive-flip-side.html?pagewanted=2&_r=0

Embodied restorying is a way to work through the dominant grand narrative of traditional stress psychology, and understanding its hegemonic project, deconstruct its power and influence, in-order-to find liberation by reclaiming Little Wow Moments of exception to the grand narrative of stress, reconnect with spirit, fin ways to do soul healing. Traditional tress psychology continues its colonial and neocolonial project, and its exported wholesale to the Third world. It is unimaginative, and as the science spread it is replicated in psychology research full of stress stereotype and stigma. In the words of Duran and Duran (1995: 26) “clinical psychology is extremely narrow-minded” and “based on a utilitarian worldview” of whatever works. “Of the traditional concepts, soul loss may be the most difficult for the Western worldview to accept” (ibid.: 20).

PART VI: Enter the Positive Psychology Movement

Fortunately, the military is begin to face the stigma of stress in its forces head on. Why? Veterans who seek help are less apt to commit suicide. 22 veterans a day commit suicide. Of these only one is active military. Do the math. 22 times 365 is 8030. In seven years, its 56,214 which is more than Iraq and Afghanistan or about number of troops dying in combat in Vietnam.Most of the veterans who commit suicide, are out of the military, one to three years, and have not sought help because of media stereotypes in U.S. Films, news reports, magazine, articles, and in what they have heard about stress psychology. What the military is using lately is Global Assessment Tool 2.0. has social, emotional, physical, family, and spiritual dimensions. http://csf2.army.mil/downloads/ArmyFitOne-Pager.pdf

Five ways to Cope with Stress in the New Military (source Army Military site; or Fort Bliss Bugle)

Physical - Weekly exercise can protect your brain from the
aging process and delay the onset of neurodegenerative
disease. Hence, not only does exercise improve and maintain
your physical health, it can improve and maintain your
psychological health!

Social - Effective communication with peers and leaders
requires effort and practice. Remember to use the IDEAL
model when you are faced with a challenge or conflict.

Spiritual - Some would contend that interacting with
animals builds the spirit. Research in the human-animal
bond support the idea that animals make us more human.
Spending time with your pet is probably good for both of
You!

Emotional - The brain and nervous system respond best
when given structure. Creating a routine for an important
task can focus the brain and body on the necessary steps to
achieving success, while lowering counterproductive levels
of stress that inhibit emotional balance.

Family - When they can’t solve problems on their own,
resilient families reach out for help by turning to extended
family, friends, neighbors, community services and/or
Counseling.

"In less than two years — without a single pilot or study — the program has been rolled out to the Army’s one million solders. Every soldier takes the General Assessment Tool, a 105-question survey, which asks soldiers to respond to statements like, “In uncertain times I usually expect the best” (Cornum would score high on this), or “If something can go wrong for me, it usually will.” Depending on how soldiers score, they are prompted to complete online training in any of the program’s five key areas: physical, emotional, social, family and spiritual (which could mean either religious faith or personal reflection). The Master Resilience Trainer program, part of this larger effort, is supposed to turn the noncommissioned officers closest to young soldiers into teachers of positive psychology” source

"The traditional view of trauma was bifurcated: you either got P.T.S.D. or you were fine. Researchers today have a messier perspective. It is normal to have problems following trauma. You should lose sleep, have terrible images replay in your head, be racked by guilt or fear. Some people suffer these normal post-trauma reactions to one degree or another and recover, returning to a relatively normal state within weeks or months of the event. Others appear unchanged at first, only to react months or even years later. The majority of these people also recover” source.

The military is moving away from traditional stress psychology of PTSD and moving to flip it to PTSG - Researchers have found evidence of post-traumatic growth in cultures across the globe (Israel, Turkey, etc.). PTSG is using animals, storytelling, and confronting the old stigmas.
Definition: Master Resilience Training (MRT)

Download and Read 3 MRT stories.

1. First story

2. Second story

3. Third story

PART VII: Welcome to Leviathan!

Leviathan is the name Thomas Hobbes (1651) gave to the swarm of institutions that are the State. Now Leviathan has gone global, and with it stress has morphed from something haunting veterans and abused women, to the daily malady of all those living in global capitalism. Leviathan recruits heroes to fight its global wars. However, there is heightened perceptions of community-based stigma in U.S. culture that is a barrier to treatment for the stress of combat theatres (Stotzer, Whealin, & Darden, 2012: 2).

The authentic self of the veteran is haunted by many inauthentic selves, many of them part of the commodification of stress and depression instruments, treatments, insurance claims, etc.

Meanwhile, poplular culture engages in stigma-production. Popular culture has taken up the cause of Leviathn, creating narratives of the veteran's character, as victim. A veteran, according to the movies of popular culture must narrate the requisite stress symptoms, report vivid flashbacks, in order to get veteran's benefits. Stress is now what Lyotard calls a 'grand narrative' that institutions create and perpetuate, and veterans must emulate.

Veterans across the U.S. enter America's Wounded Warrior Outreach Program. Some are coming back from multiple deployments, and redeployments. They are ready to head for home. They find considerable stigma about getting help for stress, when they return to stateside. A study of Native American and Latino veterans identified several barriers to VA services: 85 percent felt “VA care-givers know little about ethnic cultures," and 79 percent felt that “VA care-givers have problems talking with ethnic veterans" (Nugent et al. 2000). 

Meanwhile, in this blaming the victim culture, the structural flaws perpetuating stress without relief assault the authentic self of the veteran, who faves barriers to treatment, or gets no treatment at all, except that which blames the victim, for any and all veteran distress. I propose a new approach to Restorying as a way to help the veteran reclaim their authentic self, and do battle amongst all the inauthentic cultural ways of stress is being created, narrated, and perpetuated by Leviathan.

PART VIII: Diagnostic and Statistical Manual of Mental Disorders

There is now so much stigma around the words 'stress' and 'anxiety' and especially 'PTSD' that our veterans on active duty and those seperated from the military do not go for services. Veterans returning from deployment, game the PTSD tests to avoid being detained, stigmatized, and/or losing rank or assignment.

PTSD has been changing as a frame over the decades. This is reflected in how PTSD is defined differently in the Diagnostic and Statistical Manual of Mental Disorders (known as DSM).

DSM Timeline of changes show that DSM keeps changing the PTSD-frame, and in 1968 removes it altogether. The PTSD-frame literally tries to protect itself from anomalies and exceptions, and the PTSD-frame tries to maximize its scope by discarding irregular data, discarding exceptions, etc. (for more on Frame Theory, please see Manfred, 1997). Here is a summary of the key changes to the PTSD-frame:

DSM-I (1952) "stress reaction" to combat, fire, earthquake, explosions (an inclusion of 1943 Technical Bulletin Medical 203, battle fatigue in WWII)

DSM-II (1968) dropping 'gross stress reaction' so there was no longer a diagnosis of war/battle fatigue; this meant that returning Vietnam War veterans had no diagnostic-frame available

DSM-III (1980) PTSD is included after 10 year political campaigning by a group of veterans known as Vietnam Veteran Against the War (VVAW), and psychiatrists Jay Lifton and Chiam Shatan

DSM-IV (1994) PTSD is changed as more and more exceptions, anomalies, contradictions, and even contrary cases emerge that the PTSD-frame cannot account for; Click for DSM-IV criteria for PTSD; result "Defining Criterion F as having both clinically significant psychological distress and functional impairment lowered the diagnostic threshold to a greater degree than did either distress or impairment alone" (see article)

DSM-V (2013) PTSD-frame changes once again, since the DSM-IV re-framing of PTSD is still not able to stem the tidal wave on frame-contradictions; The change is from a diagnostic to a dimensional approach and "The DSM-5 chapter on anxiety disorder no longer includes obsessive-compulsive disorder (which is included with the obsessive-compulsive and related disorders) or posttraumatic stress disorder and acute stress disorder (which is included with the trauma- and stressor-related disorders). However, the sequential order of these chapters in DSM-5 reflects the close relationships among them" (see APA summary of changes); Results of this most recent frame-change, "Females showed significantly higher DSM-5 PTSD rates and rates of endorsement of almost all DSM-5 PTSD criteria. Significant gender differences emerged in almost half of PTSD symptomatological criteria with women reporting higher rates in 8 of them, while men in only one (a new symptom in DSM-5: reckless or self-destructive behavior)" (see article).

DSM-V addressed PTSD as an anxiety disorder;

In DSM-IV, PTSD is restricted to exposure to actual or threatened death, serious injury or sexual violation. The exposure must result from one or more of the following 4 scenarios, in which the individual:

• directly experiences the traumatic event;

• witnesses the traumatic event in person;

• learns that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental); or

• experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related).

 

In CONCLUSION: The problem, of course is the PTSD-frame is invludenced by media, pictures, TV and movies, so that veterans seeking PTSD benefits and treatments must mimick the symptoms in the cultural trope to satisfy the political, pharmeceutical, and medical framing of what constitutes PTSD in any given decade of DSM changes. Meanwhile, viable alternatives to the dominant med and therapy treatment protocols go begging. And sources of stressors outside the PTSD-frame are marginalized, untreated, not subject to insurance medical claims, etc.

 

Meanwhile an entire industry has flourshed between 1980 and 2014 that makes stress the total responsiblity of the victims of stress.

Diagnostic and Statistical Manual of Mental Disorders (DSM) is a manual that teams of experts in various field publish. The Apermican Psychological Association has been piad $30 million for its manuals. That are used to do diagnosis, design treatments, and decide on insurance payments and government benifit payouts. Meanwhile there is so much stigma attached to stress that few are seeking effective treatment.

The most hghly stigmatized stress of all stress, is PTSD. It is now so convoluted and unreliable that the Mental Health Association questions its validity and its reliablity as a measuring instrument, as a diagnosis, and its treatments are now equally suspect.

Stress came into being in DSM-I as anxiety disorder. It changed somewhat in DSM-II. PTSD came into being in the manual called DSM-III (1980) and has been redeployed differently in DSM-V (2013). A key difference is that DSM-III treats PTSD as an entity (aka category), whereas DSM-V treats PTSD as dimensions. Another difference is that test/diagnostic items in DSM-III have gone missing in action in DSM-V. As a dimensional approach to PTSD, DSM-V does not posit a threshold of PTSD, such as low-magnitude versus high-magnitude PTSD. I will argue below that PTSD has been dematerialized between DSM-III and DSM-IV, and that this dematerializtion is an example of organizational storytelling.

" Previous editions of DSM used a strictly categorical model requiring a clinician to determine that a disorder was present or absent. The dimensional approach, which allows a clinician more latitude to assess the severity of a condition and does not imply a concrete threshold between “normality” and a disorder, is now incorporated via select diagnoses” ... "To ensure DSM-5 is not overly disruptive to clinical practice, its spectrum measures are compatible with categorical definitions” (American Psychiatry Association, book publishing organization)

Does PTSD have any construct validity? Does the validity of inferences that observations or measurement tools of PTSD actually represent or measure the construct being investigated? Could it be that PTSD is a dimensional-multiplicity, not one PTSD entity? PTSD has become a spectrum of categories or is it dimensions (that answer depends upon if you subscribe to DSM-III categories or DSM-V dimensions) from reaction to loss of a parent or child, cancer, change, etc. to bullying in the school yard up to reactions combat, torture, etc.

WHAT IS HAPPENING TO PTSD BETWEEN DSM-III (1980) AND DSM-V (2013)?

My question to you, is if PTSD is different in DSM-V (published on May 18, 2013) than it was in DSM-III (1980 version) and since the framing-construct is being challenged so widely on validity issues, for its overlap with other psychiatric categories, then should we expand our inquiry to include sampling the wider population than just the military, so we can sort out this morphing of PTSD?

Further, as organizational storytelling scholars, if PTSD-framing has morphed into a multiplicity of entities, and is no longer, and perhaps never was a unitary construct or category, then it would seem that we need to study the entire communication processes of organizations, how PTSD-frame gets created by institutions, then foisted on the unsuspecting veterans, and their families. If the statistics are accurate, then 94% of the veteran’s diagnosed with PTSD are seeking compensation, which encourages exaggeration of the storytelling by veterans as well as insurance companies, therapists, etc. in order to get compensated.

PTSD is the most controversial 'disorder' of all disorders in DSM

If PTSD is as Shepard (2001) says everything from "surviving Auschwitz and that of being told rude jokes at work” is not the whole PTSD construct just nonsense to begin with? If PTSD is a social constructivism, and not a biological or a psychiatric mental disorder, then we are studying a phenomenon that is what I am calling, Leviathan. Spitzer & Wakefield (2007: 233) also wrote, "Since its introduction into DSM-III in 1980, no other DSM diagnosis, with the exception of Dissociative Identity Disorder... has generated so much controversy in the field as to the boundaries of the disorder, diagnostic criteria, central assumptions, clinical utility, and prevalence in various populations." Could it be as Wakefield and Horwitz (2007) that institutions advancing PTSD transformed normal sorrow of combat veterans into various stress and depressive disorders? Derek Summerfield in his book review of Rosen & Frueh (2010) concludes, "It is ironic that research spurred by the introduction of posttraumatic stress disorder (PTSD) has come to challenge almost every aspect of the construct’s originating assumptions.” See Derek Summerfield's book review. Summerfield adds, "Rosen notes that normal and even expected reactions to a traumatic experience, such as anger or uncertainties about the future, can now be referred to as ‘symptoms’, and that this labelling is encouraged by such terms as ‘sub-syndromal’, ‘sub-threshold’, ‘partial’ and (my favorite) ‘delayed-onset’ PTSD.” (Ibid).

PTSD plays a spectacle role in the courtroom, and in the entire compensation industry. 94% of U.S. Veterans are seeking compensation for the U.S. Department of Veterans Affairs. Is there incentive to spin the storytelling of PTSD, play the role, so that, what academics think it PTSD, is actually a negotiation to get institutions to pay compensation, disability, give benefits?

AGENTIAL CUTS AND Stress

There is another important question. What if stress actually is an ontological entity? Where if instead of blaming the victims of stress, we actually made it OK for veterans to get some effective help?

The conflated storytelling about stress is used to succeed in getting Veteran's Benefits. But this only muddies the water. The stigma increases. And what if what we take-for-granted about stess, its flashbacks, with all the coming home from war movies,has rematerialized stess into a cultural trope?

Here is my materialism storytelling take on it. Stess (& depression) is how various institutions from the VA, the military, insurance companies, DSM manual publishers have carved the construct 'stress' storytelling by making 'agential cuts.' Karen Barad (2003: 815) gives this extended definition and discussion of 'agential cut':

"A specific intra-action (involving a specific material configuration of the 'apparatus of observation') enacts an agential cut… in contrast to the Cartesian cut---an inherent distinction---between subject and object… effecting a separation between 'subject' and 'object.' ..."

The category/dimension of stess does not preexist the relationship to some particular population. That relationship is made into an 'abstract relata' as it DSM carves it out in the agential cuts by the experts creating it. DSM manuals and their writers, and the associations and publishers distributing them --- enact what Barad (2003: 815) calls "agential separability." Stress gets externalized from the relationship of the authors of 'stress instruments and protocols,' and the veterans and others, that supposedly, allegedly, have stress. Barad (ibid) adds "The notion of agential separability is of fundamental importance, for in the absence of a classical ontological condition of exteriority between observer and observed it provides the condition of a possibility of objectivity." In other words, the ontological condition of stress is harder to reach since the relation between observer and observed is severed.

Here is the kicker:

"Moreover, the agential cut enacts a local causal structure local "components' of a phenomenon in the marking of the 'measuring agencies; ('effect') by the 'measured object' ('cause')' Hence the notion of intra-actions constitutes a reworking of the traditional notion of causality" (Ibid, p. 815).

Stress as category or dimension of DSM manual, enacts the local causal structure, particularly in DSM-V in the veteran, in the 'measured object' of reliving trauma memory, as 'cause' of the disorder. The intra-actions between storytelling PTSD by the clinicians and the materiality of PTSD in the body of the veteran is reworked in DSM-V. The traditional not of causality of PTSD, is war, violence, assault, battery by somebody or some institution caused the trauma in the body, DSM-III called PTSD. The point of the agential cutting going on it to make sure that institutions blame the victims of war for PTSD, the victims of abuse for PTSD, and never ever blame the institutions for violence and trauma.

PART IX: WELCOME TO THE LEVIATHAN OF STRESS CREATION FOR PROFIT

Leviathan is Thomas Hobbes (1651) word for a hoard of institutions. A hoard of institutions from psychiatry, DSM, military, university, psychology, political, etc. are complicit in materializing the storytelling and the embodiment of stress in many populations. From an organizational storytelling standpoint, for me, this means that there is a materialization, dematerialization, and rematerialization cycle of stess.

Various institutions are creating processes that materialize stess as a construct, as a disorder, as a treatment , and a label for such a variety of anxieties, physiologies, memory loops, etc. that the whole construct of stess is quite absurd.

The dematerialization of PTSD can be studied in the ways DSM-V dematerialized aspects of stress important to the the DSM-III architects. It would be interesting to pin down what questions in the stress diagnosis (& treatment) dematerialized (were edited out of the test) between DSM-III and DSM-V.

There is a rematerialization process going on among the various institutions and academic disciplines that are concerned with forms of stress. Elements (test items, traits) in what constitutes stess are being rematerialized. I notice for example, in the online DSM-V tests for anxiety disorder, which is supposedly highly correlated to stess indicator-instruments, that in anxiety disorder the core assumptions are physiological, and the test questions are about anxiety being embodied. Compare these sort of embodiment test items to how stress in DSM-V is even more disembodied than it was in DSM-III. In sum, the organizational storytelling of stress has changed since stress was introduced in DSM-I and PTSD in DSM-III in 1980, and been rematerialized as more disembodied than ever in DSM-V.

What are the implications of this shift in organizational storytelling of stess for our interdisciplinary study? For me, it is that the ways of restorying stess involve materialization, dematerialization, and rematerialization processes of many different organizations. The Quantum Restorying and the equine skill training of stress management training by my colleagues and I. We proposing both skill training approaches are about embodiment, stress embodied in the body, and the stress defined by culture, by Leviathan, in ways that brings profit to stress-drug distributors, stress therapists, stress researchers. We may be better served with an stess/anxiety disorder measurement pre and post to such interventions that gets at embodiment than with the DSM-V test which is completely disembodied, about reliving memory of trauma, and that affecting behavior (withdrawing from the social and from intimacy, such as in the cognitive-behavior approach to stess).

One of the dematerializations is DSM-III took a categorical approach to determining PTSD, so for example, a veteran had low-magnitude or high-magnitude, or even delayed-reaction PTSD. However, "To ensure DSM-5 is not overly disruptive to clinical practice, its spectrum measures are compatible with categorical definitions” (See online text).

You can see the materialization/dematerialization/rematerialization in the academic storytelling about PTSD. Is PTSD a categorical entity or a dimensional range? PTSD can be constructed as categorical clinical entities and/or as a range of specifiers, such as “mild,” “moderate,” and “severe,” which introduce a dimensional aspect (Stein online text). Stein concludes "A potential disadvantage of categorical approaches is that they may encourage reification and oversimplification of complex entities with multiple overt symptoms and underlying mechanisms. A dimensional perspective allows for a more fine-grained approach, but also has significant potential disadvantages. It is useful to employ categorical and dimensional approaches in tandem, in both clinical and research settings.”

Spitzer, First, and Wakefield (2007:233-241) conclude in a special issue of the Journal of Anxiety Disorders:

there are "critical issues and core assumptions that underlie the diagnostic construct of posttraumatic stress disorder. Rather than addressing specific points raised in these papers, we consider the issues and their implications for redefining PTSD and associated disorders in the DSM-V. Specific proposals are advanced to tighten definitional criteria for traumatic events and posttraumatic symptoms. We believe the more stringent criteria express the intent of the PTSD category and will promote more effective research on whether that intent was legitimate or based on misconceptions.”

NEW MEASUREMENT NEEDED: STRESS in STORYTELLING AND its MANUFACTURE IN LEVIATHAN

Finally, we would like you to put aside the way stess is diagnosed, and how popular culture (TV, news stories, books, etc.) portray you as victim of stress. Rather, we ask you to tell the authentic story of stess itself. This is not reliving the trauma events, or their memories, rather we are asking you to just tell the story of your home-coming, and ways you were expected to have stess.   

Findings of Stress Research are Contrary to the Most Recommended Treatment for Veterans

Stress affects the lives of millions of people who have encountered war, domestic violence, rape, major illnesses, loss of a spouse or child, natural disasters, and other traumatic events. Anyone including children can contract stess. One of the problems is that stess as a medically defined condition has been given a very generalized definition in the media, in popular culture, in the movies, TV shows, and news reporting. And in popular culture soldiers are expected to tough it out, man-up, and never seek help, never go for therapy, be one of those that culture stigmatizes. It is stigma by popular culture, and lets med everybody, pharmecutical industry that is at the root of stress.

When the war fought is justified and legitimate, then no stess is expected. The most recommended treatment is 1. UNOFFICIALLY: Don't report it, you will never be promoted. Leave it out of all your storytelling.

If the war is unjustified, did not go as the State planned it, or otherwise questionable, then, as with Vietnam, the returning veteran is expected to have stess, to tell it in the home-coming story, to report the usual symptoms. The the second most recommended treatment is prescribed: Repeated reliving of the trauma event, its flashbacks, so as to desensitize the effect of the trauma.

Does this make sense? That the occurrence of stess, including PTSD (whatever that is today, in the latest DSM) is a matter of the popularity of the war itself, not the trauma events? Click here.

The main therapy recommended is problematic. How does reliving a trauma memory help overcome the effects?

"Rather than these reactions naturally fading over the course of time Field suggests that they are kept alive by the litigation in which patients may be involved, the succession of legal and medical reports, and the anticipation of having to appear in court, constantly refreshes the memories and the unpleasant emotions that accompany them" (Brewin, 2003: 30).

Add to this the media keeps alive the expectation and anticipation that returning veterans include all the usual symptoms in the coming-home story.