Appendix D: Preface from the "Whackomole" Book

This preface was originally written for another book which was issued as an OPED protest of media-alleged mal treatment of veteran mental health care at the beginning (2006-2007)of the twenty-first century. The referenced work's title is The Great Evidenced-Based, Cognitive Behavioral Therapy, Self Help and Government Merger: Monopolistic Cultural Infusions of Pharmacological and Behavioral Whack-a-Mole and Combat Psychological Trauma; Cope or Cure!? by Jesse W. Collins II.

I've placed this information in this online book because it highlights the relationship of trauma, its Etiotropic management, and application to the problem solving efforts involved in this partifcular discussion. They are not just how to define and prevent ruination of individual and collective identity in clinical scenarios, but how to stop or otherwise intercede externally generated attacks upon that base of a person's, community's and nation's decision making. This preface, then, summarizes the gist of this body of knowledge, how it came about, and where to direct a search to get the details of its epistemology and implementation.

Preface

The entire Etiotropic underpinned work encompassing nearly forty years and referenced in this book (and thus on the ETM TRT SHOM System of Health Care website) was initiated out of default by the psychological and medical professions to define and thus address coherently, congruently and competently the human consciousness as it adapted to psychological trauma-causing events and their human psychological consequences. However, in my role as a founder, CEO and Clinical and Compliance Directors of a national group of licensed Chemical Dependency and Psychological trauma treatment facilities, trainer of psychotherapists of most disciplines and epistemologies and their  counterparts coming from the various theological constructs, and the Certifying Authority for the Etiotropic Trauma Management and Treatment Clinical Therapist and Counselor Training and Certification program, I treated that group of professionals and thus their attendant organizations including academic ones representing myriad disciplines, epistemologies, ideologies and theologies with deference ─ respectful regard, even when those models clashed antagonistically so with other thought constructs, backgrounds and trainings, to include my own. I believed that in the main and as individuals most professionals’, at least at ground implementation levels, hearts and minds were focused upon meeting their responsibilities to their patients ─ no matter my always ongoing managerial requirement to understand and account for the widest perspective possible in order to respond effectively to that increasing potpourri of intellect and learning ─ that those efforts were being encumbered by cultural systemic forces influencing quality of delivery and service performance beyond their individual professional understandings and controls.

Times have changed. Although I’m not making this issue a life crusade, I do intend in this particular book, my fortieth, I think, related to the Etiotropic approach to psychological trauma, to interpret for the reader, the parts of the society needing help related to these contents, and the psychological profession what I consider to be gross negligence if not mal- and misfeasance by its leadership in the management of psychological trauma as it occurs and presents through its host for assistance or other remedy or at least a competent response in and for this culture. 

Summarizing what I’m going to tell you in this book:

1.      Psychological trauma is not a behavioral issue; it is about human identity, to include human ontology in trauma harmed identity’s restoration.

2.      Despite DSM categorizations and promulgation to the contrary, psychological trauma and its behavioral manifestations should not be treated as a disorder; they are a natural phylogenetically-directed integrative neuromolecular process of extinction through the Long Term Potentiation and Long Term Depression inter-hibiting interplays of those neural synaptic processes that provide the substrate for the psychological concept of identity; although Behaviorism takes off on synaptic interplay, its molecular learning and storage variables are different from those representing identity. Worse, they convolute non homogenously. The disorder conceptualization when applied as an integral component ─ as it is in Cognitive Behavioral Therapy ─ within the helping interaction impedes the brain integration effort; the Behaviorists, Cognitive Behaviorists, or whatever they are calling themselves most recently in the current era, are forcing inappropriate learning upon the natural neuromolecular integrative process attending identity extinction.

3.      Behavioral (including the reformative Cognitive-Behavioral delineation) remedies that attempt to alter post-trauma behavior either interfere with molecular extinction or worse exacerbate the consequences of that interference, in the process changing the natural remedy into a life injury, making it impossible to address successfully from both that epistemology (Behavioral) and almost any other. Hence, that group holds the view that the behavioral delineation, PTSD, is incurable. We agree that it is not only incurable from within the Behaviorism model, but that approach, itself, becomes the principal cause of the new and ever continuing both individual and social management problem.

4.      Where pharmacological methods are necessary for schizophrenia and bipolar based illnesses, those approaches can and do impede the referenced natural extinction activity that otherwise end with complete resolution of psychological trauma and its behavioral manifestations; combining pharmacological applications with Cognitive Behavioral Therapy assures trauma’s incurability for life and a concomitant dependence on medical professionals and pharmaceutical corporate organizations for services and products that sustain those vendors with lifetime economic markets and the users with ever continuing ─ but pathetically unnecessary when compared to the Etiotropic catch-and-release-metaphorically-styled (meaning instead of turning a tragedy into a helper’s house in suburbia or automobile payment, to identify the trauma’s etiological influence, cure it as in incrementally facilitating it to complete resolution, and then get out of the victim/target/patient/client’s way) program ─  psychological sustenance.

5.      The Behavioral disorder promulgation stigmatizes those, particularly active duty military personnel and veterans to which the nomenclature is appended, results in systemic management intolerances that impede address of the actual issues involved; the impediments retard organizational efficiency and performance.

6.      Caring about individual citizens influenced by trauma facilitates the brain integrative process for those affected; that caring attribute, particularly when it is focused at the locus during the integrative process, is more important than objectifying the trauma affecteds’ injuries into the scientific lexicon, and to be certain taking the minds of beneficiaries (patients of Behaviorists or other members of the public) of the helping effort in there with you. In fact, that approach underpinned by objectification of the issue through intellectual interpretation of the malady gets in the way of what otherwise is a very simple remedy.

7.      The Behavioral approach to trauma is inherently a hegemonic  thought – management model that itself is produced out of trauma. It will always attempt to dominate its ontological and existential – focused counterparts or competitors, in the process ironically shutting down the very and only capacity of the human being to learn his or her way out of a perpetrator-contrived condition that either causes aggression or allows it to continue systemically.

8.      The conflict between Behavioral- and ontological-based managements is extended into social management or macro government management configurations; when the ontological side wanes, lives are lost in the millions and big money is unnecessarily spent.

9.      Behaviorism is a Nosotropic, that is, symptom-focused remedy. The model I represent is an Etiotropic, meaning etiologically-focused remedy. When applied to psychological trauma, the Nosotropic approach is engineered to always fail at both individual and systemic levels. The Etiotropic approach will always succeed, albeit if the aggressive politics utilized by the Nosotropic system of care do not get in the way; study and subsequent adaptation of the Etiotropic paradigm demonstrates clearly, unequivocally and incontrovertibly the failures that are otherwise invisible for those practitioners operating from within the Behavioral modality’s epistemology and application.

10.  Behavioral models may have positive benefits when applied to certain mental health issues; psychological trauma and Post-Traumatic Stress Disorder (PTSD) are not two of them.

11.  Psychological trauma and PTSD are routinely and wholly curable, depending upon the model employed; politics ─ not science, rational thought or other applications of logic and reason ─ prevent that cure from being made available where needed by individual trauma victims and trauma affected organizations.

12.  One purpose of this book is to change that. Another is to remove the deleterious influences of Behaviorism and its reformation, Cognitive Behavioral Therapy (CBT), on the treatment and management of psychological trauma so that I and others who follow the Etiotropic course can do our jobs: achieve the stated goals of the Etiotropic Trauma Management (ETM) program.

13.  The Nosotropic approach to trauma treatment and management has created and is creating an ever burgeoning to eventually become unwieldy, national identity-changing, and inevitably unmanageable and unfundable government operational national defense quagmire that not just portends, but assures catastrophe for the security of this country and western civilization; the Etiotropic Trauma Management approach can intervene upon that coming calamity and prevent that outcome, although it must be done quickly – soon if those entities as we know them are to be saved.

14.  The Evidence-Based model strengthens - magnifies (makes worse) the natural deficiencies attending the Nosotropic approach to the address of psychological trauma and PTSD and adds the increasing prospects of fraud in its application.

15.  Age and health necessitate this author’s telling this story in a manner where it can be usable by the public in his extended (in perpetuity) absence.

16.  Competing with professional and intellectual inanity in the public management sector can be done with tolerance unless that competitor’s lack is attended by aggressive arrogance, sometimes just arrogance by itself. In some instances, that intellectual ─ or otherwise learning ─ disorder often responds positively attitudinally, albeit not always favorably emotionally, to civil ridicule.

 History: Learning from a Unique Facility Configuration

In the early 1980s, something happened in our industry that would set our facility, and thus me as its primary director, on a learning path that would redefine how differing disciplines from the psychological and substance abuse professions would interrelate or not. The Reagan White House convened a presidential study and advisory group to ascertain and then make recommendations for a model for the treatment of families particularly affected by substance abuse, at the time termed Chemical Dependency. Our consultants, the Johnson Institute in Minneapolis, Minnesota, who in that era were international leaders in that field, participated in that effort. The President and his wife would follow that work with a special public televised message emphasizing the nation’s (America’s) need and thus the Reagans’ admonitions to the culture to focus with treatment, understanding and special care upon so affected families. With the guidance of the consultants and through our own private funding efforts, we initiated that model in Houston, Texas, while the consultants encumbered by their own funding difficulties were unable to do so in Minnesota. Worse, they lost much of their staff who had participated in the development and commission planning activities. And as we were informed, apparently no other organization in the country had followed through to implement the recommendations. We were then on our own to develop the paradigm from the presidential committee ideas based on the premises originating from and influenced by the Minnesota Model for Chemical Dependency treatment.

That Presidential commission’s address of the issue produced a management approach to individual and family treatment that had a much broader and simultaneously detailed view of what such care would entail. It recommended individualized treatment for family members as identified patients instead of as just collateral participants, which latter approach was the norm for the times. And because there was no such treatment system in existence at the time of the design, implementation would entail and include a process of discovery.

Coincident to that learning activity, the State of Texas was initiating a new licensure program for Alcoholism treatment facilities. It established a higher standard for facility operations that closely paralleled that employed by and available from the Joint Commission on Accreditation of Hospitals (JCAH), later to become JCAHO, standing for accreditation of Healthcare Organizations.

To make that recommended model comply with state licensure and JCAHO requirements, each family member would have to and did at our facilities receive an individualized treatment planning and charting system that was directed not just to and upon solitary perspectives of the self, but with a focus on that person’s role in the various relationships comprising a family, and then to include in concert the view of the family as a whole; all stratifications received similar emphasis. That is, all of our patients / clients were formally addressed intrapsychically, interactionally and systemically. Defining true family treatment, we mandated with every Chemically Dependent Person (in that era also termed the CDP) that all family members to age five be required to participate (or we would not accept the CDP for care – referring them out). Thus family treatment was no longer being restricted to the collateral concept that otherwise ruled the inpatient treatment culture where the facility’s focus was primarily if not only upon the CDP. Generally speaking, and I’ve addressed this issue in detail in other documents pertaining to ETM’s development,  everybody else in those schemas might meet with a family therapists once a week, and then be sent to Al Anon, which of course being an independent self-help entity did not provide for charting, thus documented discovery. In some instances thanks to the Minnesota paradigms like St. Mary’s Hospital in Minneapolis, which was then emulated in several other areas of this country, families were invited to participate for a family week. But all total, there was not equal consideration (to the CDP) for the family’s well being in the residential care models of the time.

For those of you who don’t understand what those comparison’s mean, here is the way the new or our family treatment model looked in application. When a family presented, each person was accorded his or her own individual therapist responsible for that person’s progress or not; a relationship specialist whose job it was to facilitate interactional matters in, for example, private settings and couple’s groups (where they were used); and with a family therapist having responsibility for facilitating and charting that unit’s (the family as a whole) progress. It was not uncommon in our health care delivery schema for each age or peer and relational representation to also have a different therapist representing the various focuses. A family would be attended to by as many as five to seven team members. That facility then contracted with families to participate over a two year period, which in the main all did do once completing the initial acute or entry phase of care. And all of this activity was then supervised for congruity and performance by the various government and JCAHO compliance - accrediting organizations.

As I’m sure that you can see, individual practitioners who were trained in the myriad various disciplines were required to function as integral components of a team. The children’s therapists, were scheduled to interface with the individual therapists representing the other family members, as well as with the therapists having interactional (specific relationship responsibilities pertaining to those individuals) and overall family clinical management and other response duties. And of course the CDP was accommodated Alcoholism Counselors by individual address of the bio-psychological issues attending the pathological use as well as how that person’s use affected his or her relationships (like a marriage where the CDP was a married adult) with the other members of the family. Therapists bringing their own epistemologies and trying to apply attendant methodologies without regard for differing meanings and effects than that being applied by other team members who were seeing the same people in the other contexts were required to learn the homogenous model and function accordingly with the overlaying treatment and management system.

Sounds easy; except that it was not. There were and are two primary problematic influences with such management efforts.

Firstly, and unlike ours, therapists traditionally worked in clinics where a single patient or a family was assigned to them, usually seen alone. The type of modality used by the therapist was not an issue as long as it was deemed to have professional merit. But more significantly, the facility’s management was not encumbered or otherwise challenged by the differences employed in the various clinicians’ modalities used. Crossover patients were rare; thus they saw little to no conflict between helping modalities. In this health care delivery mechanism, all qualifying therapies were deemed acceptable, good or equal. Comparison and contrast for patient understanding was not the rule; thus conflict between helping notions did not present either for those patients or the facilities’ managements. In those settings, the final responsibility for the clinical progress or not lay with the single practitioners. Facility managers were and could even be just administrative managers, and not clinical ones. Therefore working in a team schematic as we used where the different epistemologies required homogenation by a central leadership was uniquely different, sometimes burdensome, and always demanding of extraordinary learning: continuous study, focus and research regarding the differences, and necessitating constant reconciliation based discussion.

Secondly, therapists and counselors, particularly those who think of themselves as scientists more so than as helpers, bring methodologies ensconced in personal issues often related in the arena where pathological chemical use is involved to the same issues and dynamics affecting patients. Therapists, therefore, in such a management configuration are not just having to adapt objectively to another methodology, but they come deeply ingrained personally in and thus reliant upon those training models, which may, and in most cases from my experience as a trainer of this population, support their own psychopathologies developed in personal chemical use or familial response scenarios, for definition of themselves as well. Professional training and developmental ramifications from trauma sustained from pathological chemical use, whether affected directly as a user or family member, were convoluted unconsciously as underpinnings of professional epistemologies. And those selves – to include professional mergers of pathological personal and professional constructs – were and are not today where applicable given up easily within the team configuration. Hence, the learning that was attained in meeting that training and management challenge provided by therapists coming from the various mental health or chemical dependency disciplines became integrated into the Etiotropic management modality. That challenge was assiduously objectified and documented therein with the treatment facility manuals for operation, which in turn became subject to annual audits with the compliance processes. As you will see, the lessons learned from those experiences and meeting those management duties also provide one of the two primary influences upon the perspective from which this essay-book was written.

Creating a Cure-based Trauma Module in a Coping-based Community

The next greatest influence on the learning that constructed the Etiotropic model resulted from the development of our psychological trauma treatment module. It was termed Trauma Resolution Therapy (TRT) at the beginnings of the referenced facility operations’ address of clinical and methodological differences.  Relative to the thesis of this book, that model demonstrated the necessity of creation of a cordoned environment (called the TRT module for screening exogenous variables) for its application within both the facility clinical settings, and then with the larger communities’ helping environments. TRT was a structured psychodynamic model that could become encumbered by the conflicts attending the myriad uses of differing thought constructs not only being applied within the communities, but also utilized in the clinical operations. For example, there are times in a chemically dependent person’s progress where strong Behavioral and Cognitive Behavioral Therapy applications are best suited for the individual CDP; at another time, those same fine methods can have deleterious effects on the address of trauma caused by the use. Thus; the referenced trauma module was part of the “structure” which was intended to preclude those interruptions of the model’s logical implementation based upon the integration of its methodology with its problem identification thesis to achieve the model’s and patient’s goals. That module’s creation and the development of the policies and procedures for its use in conjunction with paralleling and sometimes countervailing helping applications was hammered out in the clinical and compliance auditing process over approximately five years. Once the efficacy and principles for administration were established in that initial period, the models were then integrated into most aspects of mental health care and eventually as the model was extended into the communities’ crisis management activities.

As a supportive explanation for those readers who’ve not been privileged to represent their organizations as compliance managers, it might be valuable to note that government and JCAHO  licensure auditors do not come to a facility representing themselves as experts in all the disciplines being used in the mental health care treatment culture. But they DO come to your organizations as experts in system management design with the goal of ensuring operational homogeneity and congruity. And those professional auditors are trained and experienced in assuring that a facility operates under an assiduous application of systems  logic in its address of all patient care variables, and that includes among other things unrelated to this discussion, the reconciliation of prospectively and actually countervailing thought constructs being professionally administered within the delivery system. For managers not used to this level of scrutiny, the process can be both rigorous and even grueling. For me the experience, which as the CEO and Compliance Officer I participated in a minimum of six audits per annum over at least five years, was edifying.  I attribute that experience as one of the cornerstones of the success of the Etiotropic Trauma Management modality as it has been extrapolated to the community for the address of similar issues considered and addressed in our facilities.

The trauma focus raised early on the address not just of trauma caused by chemical dependency, but traumatic events unrelated to the presenting issues. For example, combat, sexual assault, criminal homicide, auto accident, natural disaster and approximately twenty other trauma causes presented routinely; they were addressed as comorbid or what or now called co-occurring issues. As the facility model matured over the next decade, trauma referrals unrelated to chemical dependency were accepted, and the treatment model adapted accordingly. The total of this learning management effort produced the “Etiotropic Multiple Sources of Trauma” assessment, theory and methodology referenced in our literature. That issue has recently (in the last decade) been coined by Behaviorists as complex trauma.

Combining the family intrapsychic, interactional and systemic daedal addresses with the structured trauma resolution or psychological cure as opposed to coping approach produced a vastly different perspective of families affected pathological chemical use than that being described by the psychological profession in the literature. The combination also provided important factual differences for the determination of etiology of the use, itself. Here is a summary of the part of that good news as it relates to the issues drawn in this particular book.

1.      TRT and its precepts’ applications to the intrapsychic, interactional and systemic levels of both the individuals and units involved showed that the primary issue involving this population was psychological trauma resulting from protracted presentation of toxically caused aberrant behavior by the CDP and that the etiology of those trauma influences were harbored at the three levels in each grouping’s identity.

2.      Removal of that etiology at all three referenced stratifications of identity ended what the psychological profession influenced primarily by Behaviorism and then its spin to Cognitive Behaviorism  were beginning at the time (early 1980s) and thanks to and in accordance with the DSM III’s recognition and codification of PTSD to call symptoms of  psychological trauma or certain presentations of it to delineate a formal PTSD.

3.      Removal of the etiology with the trauma resolution model removed any appearances of the Disturbed Personality of spouses of CDPs which hypothesis predominated the psychological profession’s thinking about and views of spouses of Alcoholics; that view presupposed that disturbed personalities attracted into alcoholic relationships to meet the needs engendered by the intrapsychic level disturbances. Reversal of the trauma etiology ended the abstractions related to the attraction theory as well.

4.      Removal of the referenced etiology at the three levels meant that family members did not have to live life trying to cope indefinitely with the so called “family disease,” or also the syndrome called “co-dependency” as was the primary thesis of the competing self-help applications to such family members and as that notion was becoming adapted into the professional treatment community and simultaneously being presented in the media.

5.      Removal of the trauma’s etiology at the three levels removed what Vaillant, the author of A Natural History of Alcoholism, called the “skewed effect” that otherwise precluded families from identifying the origins of the trauma causing events – which when so removed turned out to be the CDP’s toxic behavior.

6.      The removal of the trauma etiologies provided for determination of the beginnings of the toxic influences on offending behavior, in the process giving factual testimony to the documentation of whether Alcoholism in the CDP was etiologically speaking a function of stress or biology in determining the cause.

7.      Removing trauma from the referenced three identity levels had strategic ramifications for interventions on CDP active use; removing the system’s trauma facilitated a so called bottoming process for the pathological user.

8.      The same strategic intervention that facilitated entry into sobriety for the pathological user had similar strategic ramifications for intervening on criminal perpetrators when extrapolating the intervention approach to the culture’s attempts to address violent crime; I have since applied that knowledge to the development of Strategic Human Ontological Management (SHOM)™ as I’ve recommended that it be applied culturally to the address of terrorism and other kinds of illegal violent behavior.

Management Modality Documentation

That system of care’s development and application at both clinical and community levels between the periods 1979 and 1996 (the latter being the year in which my wife and I were fully incapacitated by severe auto and other medical injuries and subsequent illnesses) which eventually encompassed nine licensed and a tenth partially so facilities, has been documented as it proceeded for professionals in print and in online publications for twenty-eight years. It, along with full descriptions of the development of the Etiotropic Trauma Treatment and Management model and its interface with the trauma resolution engine Trauma Resolution Therapy (TRT), has been detailed in several books-works: Due Diligence for the First Secular Cure of Psychological Trauma and Post Traumatic Stress Disorder (1990, 2007); Etiotropic Trauma Management (ETM) Trauma Resolution Therapy (TRT) Training and Certification (1989, 2004); Guerrilla and Terrorism Warfare’s (Terrorism’s)  Pathogenesis and Cure (1991, 2003); and The Etiotropic Trauma Management Patient Educational Series (1983-1986), Trauma Resolution Therapy (TRT); a structured psychodynamic approach to the treatment of post-traumatic stress (1987); The Neurobiology of Psychological Trauma Etiology and Its Reversal with Etiotropic Trauma Management (1992). Prior to those titles’ publications, the first formal description of chemical use’s cause of psychological trauma in family members and its codification ─ previously referenced in this preface as trauma etiology existing in the three stratifications of identity ─ was published in the chemical dependency discipline’s peer review journal, “Alcoholism Magazine” (April, 1985).

Relative to a major point of this book pertaining to public management biases and mistakes currently being made by government administration and supervision of clinical and crisis management operations affecting  veteran’s care and crisis management responses to such issues as terror’s virulent influences on public decision making, all of that information was then published beginning in 1993-1994 for free review on the Internet in one of its first online distance learning programs: The ETM Tutorial. It  is maintained in its original (converted to HTML) hard coded formatat http://etiotropic.com/indextutorial.htm. The electronic publication included not just theory and application of ETM TRT, but sourced comparison and contrast articles that demonstrated and included in the training texts all issues related to the various models’ supports and competitions with each other as they were applied or not to achieve program and patient goals delineated in the treatment planning processes.

Interpreting from the ETM View Complaints with the Psychological Profession: an Impetus of this Essay / Book

As those facilities participated in their various communities, the same challenges requiring comparison and contrast discussions to enhance interface or to reconcile referral conflicts resulting from differing ways of helping presented in those differing societies. I discovered that the study and training that was required to successfully manage the facility was beneficial for addressing the identical issues reflected in the more public arena. Combining these lessons learned with those enjoyed in the treatment centers, the subsequent body of knowledge pertaining to delineating and reconciling for a common purpose the numerous ideas about the manner in which the human consciousness and how it was capable of functioning would underpin a great component of Etiotropic Trauma Management which provides the paradigmatic perspective out of which this book is written.

The essential problem with the referenced profession that I found in my role was not just its inabilities to reconcile modality differences, for example, say those existing between Behaviorism and existential – Rogerian-based, or between drug abstinence and controlled drinking models providing Chemical Dependency – Substance Abuse treatments, thought constructs and methods, but the individual professionals who used those insoluble or oil and water type systems failed to even understand, much less attempt to provide a remedy to end users ─ clients and the public ─ for the consequences of the differences on intrapsychic, interactional and systemic, to include community level problem solving.

Those failures to rationally interpret diametrically opposed ideas regarding the constitution of the human consciousness and how it functions have had catastrophic effects not just upon the lives of individual trauma victims and efficacies of our crisis management systems, but on the efficiencies of mental related health care delivery. Those failures are then built into macro management government bureaucracies having tremendous influences thereafter on how individual members of the culture identify themselves. Worse, where aspects of that delivery deserve applause, the great majority of those in the top gladiator positions imposing and exploiting for personal-career gain or hegemonic advantage for a particular idea the referenced conflicts without mitigating management devices deserve, because of  the harm that they are creating, imprisonment, or more emphatically with some additional hyperbole, the guillotine, not necessarily for criminal negligence ─ I don’t believe that crime by itself warrants capital punishment ─ but for merging arrogance with stupidity. That little get together imposes the greatest sin upon, or otherwise most preeminent impediment to, organizational learning, which when extrapolated to social management encompasses the whole of western civilization. That is, and the reason for my addition of drama to this discussion, is the great crime exposed herein.

Money’s Influences on Thesis, Modality Goals and Development

Moreover, and also related to the discussions in this book, the entire Etiotropically-based system was to be implemented in outpatient settings (ten percent of CDPs required short term in hospital detoxification), digressing then from the predominating long term and primarily influenced psychiatrically controlled intrapsychic-based residential care models attending Alcoholism treatment in that era. Thus, third party payment (and private insurance) did not support the more thorough health care delivery configuration at its initiation. And HMOs had yet to do their social damage to the mental health care industry. Eventually, individualized contracts based on performance between those insurers and companies (through their Employee Assistance Programs) would support the services.

In parallel, at the time federal and state government grants for such work were being curtailed / ended due to changes in political philosophy related to government spending, etc. Plus, I was and am a political conservative when considering government’s role in macro level social management activities; and I didn’t believe that the rest of the culture was responsible for paying for and administering my ideas about how to help the society. Hence, we privately bore that development costs, in the end capitalized at three million six hundred thousand hard dollars over the duration. Soft dollar investment, for example contributions of non-charged professional time would have pushed the amount much higher. My arguments in this piece have been, are and will be that my competitor’s helping trauma management models and the way that they fund their developments through federal and state grants / public money, are unnecessarily dedicated to creating long-term academic oriented career opportunities more so than effective services; thus those funding mechanisms build into their efforts upwardly spiraling costs: non-cure lifetime coping-based remedies mushroom through re presentations of the same client base affected by the same psychological trauma etiologies. The cure-based approach, which comes out of more efficient private economics has developed and proffers a solution that brings the problems being addressed to an end; the academia underpinned competing spiral is unnecessary making government funded academic spending projects our ever politically capitalized competitors.

The Primary Competitor: A Different Notion and thus use of Hysteria

Hysteria, which is used in this work somewhat differently from the dramatic representations exemplified by loss of control, grounds in psychological trauma’s natural propensity and methodology for defending, while simultaneously and paradoxically ending or otherwise reconciling, itself. This paradoxically-based phenomenon originates with the brain’s capacity to create and use abstractions ─ cortex located and of which the preponderance of readers will recognize as traditional thought responses during discourse also traditionally, but not necessarily always logically from an outsider’s perspective, used to figure out, that is, understand, the various meanings of loss, or to make sense of it ─ to divert the psych’s attention from the synaptic extinction which culminates in the rational identification and experience of that referenced loss, and ongoing in the core storage areas of existence.

Our model (ETM TRT SHOM) refers to that consciousness of existence as the existential aspects of identity; they in turn, are exemplified by values, beliefs, images of reality that go to  the continuity of life and its tendency to engage in, usually for advancement, relationships. These activities occurring in the individual brain spin through shared event experience, projection, transference and fusion organizationally (for example, in a military or central command to executive management units) and nationally as both systemic strengthenings and psychopathologies, at least in their behavioral interpretive appearances.

This book further argues that Behavioral (now mostly as CBT) and pharmacological methods facilitate that spin into hysteria. To counter the (when trauma-created and not managed coherently) failed management mess (incongruence in problem solving), the structured psychodynamic elements of ETM TRT SHOM are designed, and do where applied in practice to date (not yet to nation stratifications), hold the diverting abstractions ─ which present in the form of the reasoning out of trauma inspired interrogatories, for example, as do therapies that seek the meaning of an untoward (as in violent) experience, and the adaptation of interpretive philosophies and life-coping mechanisms ─ at bay while and until the process of extinction ongoing in the core synapse (meaning traces) underpinning existential identity has completed itself. When applying all three extinction facilitating strata ─ TRT (incrementally to the individual), ETM (to an organization), and SHOM (to a polity or nation; not yet applied) ─ the abstractions forming the basis of hysteria, again the intellectual process used to obfuscate extinction, are no longer required.

In my view taken from the private sector, which I believe is not just theoretically accurate but also a factual representation of reality, the mental health care industry looks like a hysterical macro managed academic and government enmeshed response to what I’ve also concluded over this era are actually very simple issues to address. And reiterating for effect and as I’ll explain in this text, where over the first thirty plus years my approach to this matter was intendedly courteous, and all my publications, academic and public presentations reflected that politically correct conflict resolution management attitude, in response to the publically noticed mal treatment of veterans in 2006-2007, I began an opinion- and editorially-based Internet blog that allowed me to confront the more controversial issues we experienced.

I’ve consolidated that activity here. I now believe the professional mental health care system has become, and particularly over the decade and a half of injury convalescences that removed me from the more seriously competing elements of this theater, obscene; and thus requires more direct if not harsher measures for righting itself. To that end, I’ve written this particular critical piece to convey that view: the lunacy or sheer nonsensical incompetence of mental health care delivery and its effects upon the otherwise conscientious individual provider, including the preponderance of professionals’ efforts being made to help ourselves, with an emphasis upon our citizenry.

Epistemology and Methodology Upbringing

The background, to include a summary of that referenced so far in this preface, that produced the Etiotropic system, and therefore from which my views and biases are conceived and engineered, took the following and now for over-thirty-years-publically-recorded path: a personal tragedy occurring in a childhood; the rigorous experience shortly thereafter of combat while serving with the United States Marine Corps in the 1960s; the aftermath of re-entry into the American culture of the time; being born into and then again out of the free enterprise system; formidable education provided by the nonpareil University of Texas School of Accounting and Business Management; a professional career in the corporate world of investment banking where among other things  endured was specialization as a statistician; following another family loss (in the mid-1970s), personal therapy with a psychiatrist who interned with Harry Stack Sullivan; career changing training in the 1970s and Texas Certification as an alcoholism / drug abuse / chemical dependency counselor having original training influences by, in and out of the Minnesota Chemical Dependency and social management response model; development and codification of ETM and attendant individual and systemic clinical and crisis management modalities; the lessons learned in pioneering, producing and managing with all final authority and responsibility for client care and their outcomes the first licensed facility programs (nine) by the State of Texas in the early to late 1980s; formal dissemination of ETM through Academia; application for twenty-five years of ETM through supervision of ETM Licensed and Certified practitioners across the culture affected by Chemical Dependency and all facets of psychological trauma;  development and codification of ETM and attendant individual and systemic clinical and crisis management modalities; and the ever continuous study and documented subject-product correlation of pertinent literature required to understand, with an emphasis on psychological trauma,  the epistemologies and governing doctrines affecting mental health professional, crisis manager and legal analyses, judgment and decision making. Moreover, this compendium of work, study and contribution has carried me now twice into fields combatting terror and thus issues pertaining to National Security interests to eventually encompass Etiotropic-based treatment and study of perpetrators of crime and heinous events used to control systems ─ to include early on as a teenager becoming an adult while serving as a Marine PFC in which one capacity was to provide protection to villagers, that is, to prevent the killing of local (small village) community leaders like Buddhists, priests, teachers, farmers, fishermen, children and other quiet beings who lived in the Central Highlands of Vietnam, to addressing the penetration by criminal gangs into school districts and other aspects of our culture, to the treatment of women and children abused by maniacal batterers and sexual assaulters, to the address of the tsunami of death caused by criminal homicides and DWIs and use of perpetrators of heinousness slaughter styled murder of the most innocent men, women and children the world has produced, always and only for the purpose of advancing a particular political ideal or other management control structure, whether it was / is engineered out of Bolshevik-, fascist-,  Nazi-, Islamist- or other Behavioral-based thought configurations.

That journey produced not just an individual cure for psychological trauma, but what I believe to be one that when strategically applied to social management responses to human and organizational contrivance-caused social destruction and despair, a cure for that, too, can be administered. That intended calamity of human-caused death can be stopped, which is one of two purposes - goals of the Etiotropic Trauma Management system of care; the other is to resolve completely, or again to cure psychological trauma as it affects every applicable, meaning individually influenced, human being.

But to do so first requires the address of incongruities in the helping ideologies and other response methods that clash, in that process then interfering with achievement of those final goals. Where there are several such methodological conflicts in Western civilization adversely affecting that interest, the one addressed in this book serves as a microcosm of the relevant issues. That is, the book focuses upon one segment of the mental health profession’s address of veterans affected by combat-caused and otherwise related psychological trauma. I believe this consideration is the core battle to be fought and won before the grander goals ─ reiterating for emphasis the two purposes of the Etiotropic Trauma Management system as a whole ─ of curing psychological trauma and ending criminal violence, can be achieved.

This is my fortieth book level, albeit nineteen of them being small patient educational pamphlets and booklets, publication on the subject of psychological trauma as addressed by Etiotropic Trauma Management. However, where all of that work was narrowly focused on the needs of my constituency ─ both ETM Certified managers, therapists and their patients ─ this is the first effort written to a wider audience, to include anyone who wants to know what I think is wrong with Western civilization’s, and particularly the American Veteran Administration’s and Department of Defense’s address of combat-caused or otherwise related psychological trauma.

The style I’ve used in this particular battle / writing is not mine. I adopted it from Marcus Tullius Cicero’s discussion and recommendations in his brilliant work, On Oratory (translation by May and Wisse), which was written and published in original scroll format just before the author’s head ─ without the body ─ was nailed to the Senate Rostrum in Rome on December 7, 43BC. I referenced the great ancient leader’s influence upon this presentation in conjunction with the way of his demise because I think there are parallel morals. One can do good work, and it still may not be recognized, assimilated and even less likely embraced for a while by a particular political leadership. And, dealing with some ideological adversaries can be tricky business.

I hope this preface has shed some light for you as to who I am ─ that is, the basis from which these views are taken ─ and on that which you are about to receive.