“Everybody’s ratting on everybody else,” Gary recalled. “You couldn’t really trust anybody and part of that therapy is to learn to trust people again.”
Dr. Kraig Strapko, an Army Special Forces Medic during the “Vietnamization” period of the early 1970s, ended his Creative Gestalt session with Gusman’s henchman ordering him to “sit down, you piece of shit.” Strapko reported that this particular social worker “treated everyone like he had a personal vendetta with them. I found it to have no therapeutic value.”
Dr. Paul Koller, team leader at the San Jose Vet Center, worked as a clinical psychologist with the Menlo Park Unit between 1982 and 1988. He agreed that gestalting “is probably the most confrontive part of the program. It’s not my style of therapy and my initial reaction was negative, but after being there six years I really have come to appreciate the need for it as a test of motivation. If they can’t do it there, it’s relatively certain that they won’t be able to complete the program, and it’s better to find it out early.”
Other clinicians agreed with Koller on this point. “I think the basic strategy of the program was to get guys, when they were new, ready for therapy,” said Ron Kurtz, Head Nurse at the Menlo Park PTSD Unit for nine years. “I thought it was an effective tool. I’m sure that guys would disagree and were probably made to feel uncomfortable at times, but it served a purpose.”
Hank Stamm, First Marines Force Recon in 1965, wonders what that purpose was. A police officer with a Masters degree in Marriage, Family, and Child Counseling, Hank completed a year-long internship in 1988 at the PTSD Unit in Menlo Park. His experience included process groups, depression groups, focus groups, and psychological testing. He sat in on the majority of the Gestalt groups that year but never participated, except to clarify a question for a vet under fire. “I thought the person who was usually doing [the confrontation] was going through his own shit. I found later that he made it a personal vendetta. I got embarrassed sometimes, the way he went at them.”
Dr. Cohen observed that, “the treatment in this field is so new, and has so little precedent, that you have to begin looking at radical ways of treating the problem. Gestalt seems particularly applicable to the PTSD issue and although it may seem brutal from the outside, it’s effective. We’re talking about a population so well-defended, and so heavily into denial, that indeed it does take a bucket of cold water to get their attention. People that wind up at the PTSD Unit at Menlo Park are one stop away from killing themselves. If indeed the condition is chronic, then the best we can hope for is to help the individual get his feelings under control and wait for the next episode. We’re still struggling with that issue.”
And Dr. Koller conceded that recidivism was high. “About one-third of the people accomplish very little, one-third really get what they came for, and one-third are somewhere in the middle. There are some folks who simply become dependent on the unit. Every time life gets hard, they hide out there. We try to discourage those.”
Gary admitted some vets abuse the system. “Working your claim” in order to profit by bureaucratic snafus is not uncommon. “The VA is paying you to be sick. If you’re service-connected and you go to the hospital, you get one hundred percent when you’re there—$1,461 a month—so, these guys get a lump sum of $10,000 for being in the hospital all this time, and they abuse themselves and use up all the money. And when it gets cold under the bridge, they have a ‘relapse,’ and go back and do it again. The longer you’re into this behavior pattern, the harder it is to break out of it. You have this invisible umbilical cord attaching you to the VA for the rest of your life.”
“This is a chronic illness,” Fred Gusman concluded, “and that means that somebody being re-hospitalized after two years might be acceptable.”
Continued in Part VI
You can read the article in its entirety in Beyond Trauma: Conversations on Traumatic Incident Reduction. See http://www.BeyondTrauma.com
