Stigma: We Shall Overcome!

This is the third of our series on Guide Dogs for the Mind. To read the previous Guide Dogs for the Mind article Training Your Own PTSD Service Dog select this LINK.

The Service Dog lifestyle is not for everyone. It is a LOT of work. You cannot simply put a cape or harness on your dog and be on your way. Check out the Psychiatric Service Dog (PSD) Lifestyle articles for further explanation.
     

In this submission Dr. Esnayra discusses something that for Veterans and Military Families coping with PTSD goes far beyond Service Dogs – the STIGMA of disabilities that are not obvious.

ROBERT L. HANAFIN
Major, U.S. Air Force-Retired
Veterans Advocacy Editor
VT News Network &
Our Troops News Ladder

It has taken decades for the military community to come to terms with the reality of Post Traumatic Stress Disorder. Many generations of veterans have suffered with this burden silently and in isolation. It has destroyed marriages and impaired relationships with loved ones. It has lead many to drink or drug and in some cases to suicide. We now know that PTSD is a type of brain disorder that occurs in some people who are exposed to extraordinary events involving loss of life or the threat of loss of life. One cannot know in advance who will be affected by PTSD. There is as-yet no genetic test that will reveal which soldiers are at risk. Currently, about 20% of returning OEF/OIF soldiers is diagnosed with PTSD. This high percentage reflects the realities of urban combat environments and repeated deployments.

We live in a society in which our justice system is premised on the notion of individual free will. Some people choose to break laws or behave badly and they reap the legal consequences. As Americans we believe this is fair and just treatment under the law. Yet, we also know there are persons who are at times compromised in their ability to make sound decisions. Consider the veteran with PTSD who ‘loses it’ in a parking lot argument with a stranger. Consider the veteran with TBI whose frontal lobe damage impairs his/her ability to modulate anger so domestic violence ensues. Should the courts take into account these veterans’ individual impairments and service to our country? Or, should all unlawful behavior be punished in exactly the same manner?

The advent of drug courts and mental health courts is society’s answer to these questions. As a people, we have decided that addictions and mental illnesses are powerful biological forces that cause some individuals to do what s/he otherwise would not do. As a result, we have established adjudication procedures that take into account one’s medical status and behavioral history. This is the civilized thing to do.

As is the case with all other animals, humans engage in stereotyped (i.e., genetically programmed) behaviors such as eating, drinking, sleeping, moving, talking, and fighting just to name a few. With the proverbial cave man in mind, how did our ancestors assess danger in their environment? How did they know whether the figures on the horizon were friends or foes? The answer is–through careful assessment of their behaviors, and when they are close enough, their speech. When the strangers display appropriate gestures and when their speech conforms to what is expected through custom or protocol, then, and only then, are the strangers deemed safe.

Unfortunately, mental illness manifests itself in speech and behavior. When we are ill, our behavior and speech deviate from the usual and expected norms. As a result, others view us with suspicion even contempt. Negative labels such as dangerous, crazy, unreliable, psycho, or disgusting are applied to us. This is the unfortunate legacy of mental illness. The non-mentally ill view our episodically aberrant behaviors and speech as threatening and they want them to stop or go away entirely. Fear is the birthplace of stigma.

Neuro-diversity is a tough pill for the average person to swallow. Most people cannot get past the unflattering visage of mental illness to consider the idea that mentally ill people have a right to innovate responsibly when it comes to psychiatric service dogs. Twelve years ago when I spoke about how a dog could be trained to assist a person living with a mental illness I was literally run out of the service dog community by persons who found my speech incredibly threatening. I was told, "People like you should not have animals at all. People like you will harm, maim or neglect animals in your care. There is nothing that a dog can do for a mentally ill person."

Thankfully, times have changed. The U.S. Department of Justice (DOJ) that oversees the enforcement of the Americans with Disabilities Act expresses overt support for Psychiatric Service Dogs in a Notice of Proposed Rulemaking that was published in the Federal Register in June 2008. It reads:

"The term service animal includes individually trained animals that do work or perform tasks for the benefit of individuals with disabilities, including psychiatric, cognitive, and mental disabilities. This language simply clarifies the Department’s longstanding position and is not a new position."

Even though the aforementioned proposed rules were eventually scuttled by the Obama administration, the quote itself still stands, because it is an articulation of DOJ’s existing policy regarding psychiatric service dogs. Let there be no confusion we are included.

The mental health community fought long and hard to achieve recognition and acceptance for psychiatric service dogs, and we are pleased to share this bounty with military veterans who are living with diagnoses of PTSD, Depression and other mental health disabilities. Many of us remember what it was like to receive our first mental health diagnosis. It was frightening, bewildering, and surreal. Some of us chose to hide the information by burying it deep in the proverbial closet for as long as it would stay there (which isn’t terribly long). Others embraced the diagnoses that finally put into perspective a lifetime of suffering. Eventually all of us came to recognize the supreme value of 24/7 human-canine partnership, both, in terms of its ability to mitigate our symptoms but also as a spiritual salve for our wounded hearts.

As difficult as it can be to adjust to the new reality of mental illness in your life, I can assure you ‘this too shall pass’. Like any other chronic medical condition, mental illness is something you eventually learn to manage. On your behalf, stigma will sift among your friends and family leaving behind only those few who are truly supportive. It’s a painful process akin to shedding an old skin, but you must go through it.

Just as military veterans ushered-in the acceptance and use of Guide Dogs after World War I, so too, will military veterans today diminish the impact of stigma in our society by being visible and proud psychiatric service dog handlers. Your stories will motivate state legislatures to stop discriminating against those who train and utilize a Psychiatric Service Dog. Your testimony will persuade the U.S. Department of Transportation to rescind its discriminatory policies against all of us who utilize a Psychiatric Service Dog in air travel. Your sacrifices for our country are inscrutable, and no one is going to deny you a viable means to recovery. I say, "Damn the torpedoes, full steam ahead" and welcome to your new family.

ABOUT THE AUTHOR:

Joan Esnayra, Ph.D. is President and founder of the Psychiatric Service Dog Society. (www.psychdog.org). Dr. Esnayra has spent the past twelve years pioneering the ‘Psychiatric Service Dog’ therapeutic model. Building upon her analytical training as a scientist, and her insights as a mental health consumer, Dr. Esnayra and members of her online community identified over 30 tasks or functions that Psychiatric Service Dogs may be trained to provide to their owners who are disabled by refractory symptoms of severe mental illness.

Dr. Esnayra and colleagues published the first clinical case study involving the use of a Psychiatric Service Dog in the Journal of Psychiatric Services. Additional publications based upon this growing body of work are in progress. The Psychiatric Service Dog model is a genuine grass-roots empowerment movement that is spreading nationally and internationally. Dr. Esnayra speaks eloquently and with authority on the subject of Psychiatric Service Dogs, by invitation, in venues all over the country.

To date, Dr. Esnayra has spoken at meetings of the President’s New Freedom Mental Health Commission, the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, the Smithsonian Institution, the National Alliance of the Mentally Ill, the Mental Health Association, the American Association of Psychiatric Nurses, the American Association of Medical Colleges, the International Society of Anthrozoology, and the Delta Society.

Most recently her interdisciplinary research group was awarded a clinical research grant from the U.S. Army to test the Psychiatric Service Dog Therapeutic Model in the context of a pilot study at Walter Reed Army Medical Center.

Robert L. Hanafin

Readers are more than welcome to use the articles I’ve posted on Veterans Today, I’ve had to take a break from VT as Veterans Issues and Peace Activism Editor and staff writer due to personal medical reasons in our military family that take away too much time needed to properly express future stories or respond to readers in a timely manner.

My association with VT since its founding in 2004 has been a very rewarding experience for me.

Retired from both the Air Force and Civil Service. Went in the regular Army at 17 during Vietnam (1968), stayed in the Army Reserve to complete my eight year commitment in 1976. Served in Air Defense Artillery, and a Mechanized Infantry Division (4MID) at Fort Carson, Co. Used the GI Bill to go to college, worked full time at the VA, and non-scholarship Air Force 2-Year ROTC program for prior service military. Commissioned in the Air Force in 1977. Served as a Military Intelligence Officer from 1977 to 1994. Upon retirement I entered retail drugstore management training with Safeway Drugs Stores in California. Retail Sales Management was not my cup of tea, so I applied my former U.S. Civil Service status with the VA to get my foot in the door at the Justice Department, and later Department of the Navy retiring with disability from the Civil Service in 2000.

I’ve been with Veterans Today since the site originated. I’m now on the Editorial Board. I was also on the Editorial Board of Our Troops News Ladder another progressive leaning Veterans and Military Family news clearing house.

I remain married for over 45 years. I am both a Vietnam Era and Gulf War Veteran. I served on Okinawa and Fort Carson, Colorado during Vietnam and in the Office of the Air Force Inspector General at Norton AFB, CA during Desert Storm. I retired from the Air Force in 1994 having worked on the Air Staff and Defense Intelligence Agency at the Pentagon.