VETERANS SHARE TRAUMA - Montreal Gazette June 13, 2009

By Alex Leduc

They spend every day listening to real-life horror stories told by Canadian Forces Veterans.

As they listen, counsellors Pierre Trépanier and Gérald Jean are keenly aware that a tale that hits too close to home could trigger their won traumatic memories.

“At first, each story would affect me,” said Trépanier. “But I realized that I need to build a wall in front of myself…it’s not because I’m cold, but it’s not my story.”

Trépanier’s job is to hear these stories from local veterans who have long needed to vent about living with the many forms of psychological trauma they inherited from their service.

As if that wasn’t challenging enough, the veteran does this while battling is his own post-traumatic stress disorder (PTSD), which he came home with after 14 years of service in the Canadian Forces. It went untreated for a decade.

“I’m going to burn out if I work too much. We have some boundaries here. If I’m not respecting them, I’m going to fall down again,” said Trépanier.

This veteran of NATO missions in the 1980s and 1990s is an essential part of a growing peer support network within the veterans community for those suffering from psychological injuries like PTSD. Combined with new treatment facilities and sensitization efforts from Veterans Affairs Canada (VAC), formal and informal peer counseling has encouraged a wave of inactive veterans to come forward and seek help for their often long-ignored psychological injuries.

Working out of Long-Pointe Base in the East end, Trépanier is the local peer support coordinator for Operational Stress Injury Social Support, or OSISS. Launched by VAC in 2001, OSISS is a national network of 45 peer support staff who have worked with over 4000 individuals within the veterans community.

OSISS has one-on-one as well as group meetings with veterans suffering from Operational Stress Injuries, the VAC term for psychological injuries sustained during service. They also counsel spouses of any such veterans who have seen their home lives affected.

The counselors and coordinators have all suffered from similar injuries and disorders, as the intention is to provide a setting where veterans can feel comfortable opening up to others who have been in their shoes. But for the staff, this interaction can sometimes trigger their own symptoms which may easily lead to burnout.

“Individuals that do a lot of one on one intense work, they suffer a great deal from burnout,” said Juan Cargnello, a VAC Psychologist who trains OSISS staff. “Sometimes we even call it vicarious traumatization whereby you’re almost experiencing the same phenomena that the client has, and you incorporate it into your own personal life, so you start to lose perspective.” “We need to respect our limits because we are not 100 per cent healed. We may never be. So we need to control ourselves and understand what we can do,” said Gérald Jean, an OSISS coordinator based out of the Saint-Jean Garrison south of Montreal.

Jean has lived with PTSD and major depression since his military career ended in 1999. He was diagnosed with PTSD in 2005. Shortly thereafter he was introduced to OSISS and began receiving counseling from Trépanier.

After Jean was hired as a coordinator in January, he and Trépanier have been taking on the challenge of helping local veterans. Both agreed to exchange any cases they can’t handle psychologically.

“If I see at the beginning that I won’t be able to handle what the veteran is telling me, I’ll ask Pierre if he’s able to take care of him, because I can’t, it resembles too much to my own trauma,” said Jean. “It doesn’t happen that often…it’s happened a few times though.” Jean and Trépanier both believe they have a handle on their responsibilities, and that they are not overworked, although their schedules can be unpredictable. Some veterans, however, think too much has been asked of them at times.

“The problem is it’s too small, there isn’t enough staff,” said UN-NATO veteran Pascal Lacoste, who has received counseling from Trépanier for several years. “They’re overwhelmed, they’re burnt out.”

Locally, OSISS is getting help. It’s coming from fellow veteran Denis Beaudin, who is providing a similar but less formal form of social support through his Veterans Canada organization.

Beaudin is a UN-NATO veteran who gets regular VAC treatment for PTSD. Over the years, he has seen many of his fellow veterans commit suicide. He started bringing together veterans for social gatherings last year when he realized that it helped many of them out of depressive states after their military careers had ended.

“There was a need. A need for the guys to reconnect. In reconnecting, the guys are saving each others lives,” said Beaudin. “With the organization, it gave me a chance to approach veterans who would have never otherwise asked for help.”

Beaudin now finds himself spending several hours a day speaking to veterans admitting long-ignored psychological issues, and has begun bringing them to local VAC facilities for treatment. Beaudin believes that since he functions outside of Canadian Forces Bases and the VAC, many veterans are more comfortable seeing him than OSISS staff.

“When we go back to a military environment, we perk up, we are on alert, on watch, and the guys don’t like that. It’s too stressful,” said Beaudin.

Trépanier does concede that it is difficult to satisfy everyone. “But they don’t have to come to me,” he said. “I always ask people if it’s a problem to come to the base. If they say yes, then I go to their home.”

Since the Montreal area Long-Pointe and Saint-Jean bases are transitional and training bases respectively, the vast majority of the veterans who interact with Beaudin and local OSISS staff are inactive veterans from peacekeeping missions and conflicts of past decades. According to Trépanier, OSISS staff are overwhelmed at bases like Valcartier near Québec City and Petawawa northwest of Ottawa where staff and soldiers are returning from Afghanistan.

One in seven such soldiers return with psychological issues, according to a McGill University study conducted in 2007.

But today’s active military can take advantage of the ongoing overhaul within the Forces and the VAC of psychological health treatment for veterans. This initiative includes education to reduce stigmas surrounding psychological injuries, screening for symptoms upon return from an overseas tour, and the creation of several new clinics, including a residential facility scheduled to open this fall at the Ste. Anne de Bellevue veterans’ hospital in the West Island. Trépanier, Jean, and Beaudin don’t spend much time with active veterans. They mostly see the faces and hear the stories of those who served and obtained their illnesses before the recent overhaul took place.

“When the guys come to see us, they’re already at the limit,” said Jean. “Either their families have told them they need to get help, or you need to go, or maybe they’ve attempted suicide.” “When we talk to veterans, they realize that they are not alone,” said Trépanier.

VAC clinicians have found that left untreated, symptoms of PTSD can become permanent. Because of stigmas within military culture associating their conditions with weakness and a previous lack of help from the veterans system, many veterans like Beaudin and Lacoste suffered for many years behind closed doors.

“Seven years went by where I didn’t want to see anyone. I was no longer able to. I had made three or four suicide attempts. I was really at the end of the road. Drinking, aggressiveness, name it. I had it all,” said Beaudin. “When we asked back in my generation, when we made a request for help, there were no resources. Zero help.”

Lacoste, a 32-year-old who Trépanier has described as one of his worst cases, nearly died in his bed from a devastating combination of physical illness and psychological trauma after returning from a peacekeeping mission in 2001. The veteran was castigated by his peers then spent years fighting with Veterans Affairs for adequate physical and psychological care, which left him cynical of their motives.

“[VAC’s] main goal is to frustrate us as much as possible with bureaucratic hoops so that veterans who are already ill and tired abandon their efforts so it can save money,” said Lacoste. His views are not unfounded. Inactive veterans face a mountain of paperwork and often years of waiting to qualify for care from VAC, a daunting task for someone suffering from one or many psychological disorders.

“It can take a year, two years, three years. And most of the time you’ll get a negative response,” said Beaudin.

OSISS staff help veterans with their paperwork, help which Trépanier appreciated before he was hired.

“It was too much, and I was all mixed up with all that. I was not able to concentrate to do all those things. It’s too heavy,” said Trépanier.

When asked for a response to such comments, Veterans Affairs Minister Greg Thompson pointed to the new off-base clinics which veterans can visit discretely, and new post-deployment screening procedures for psychological issues.

“We’ve dedicated a lot of financial resources to…making the process less cumbersome for our veterans, streamlining the process,” said Thompson. “The question is always can we do more, and my belief is we can do more and we will.”

Despite shortcomings, Lacoste feels that since OSISS councilors and veterans like Beaudin can relate to their own experiences, peer support really is making a difference.

“It’s the difference between life and death for me,” said Lacoste. “Really.”