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The origins can not be placed at the foot of one powerful individual and did not derive from a clearly thought-out, hierarchical, managerial demand. Instead, it has grown organically, from the grassroots, and has remained multidisciplinary, multinational and multi-opinioned. War Takes Center Stage Dr. Chaim Shatan was familiar with the symptoms of war. His father wrote short stories about his war experiences and the son translated them from Yiddish to English.
Shatan had gone to medical school during World War II, when physicians still received training in combat-related disorders and had evaluated men suffering from the traumatic neuroses of war Scott, And, as co-director of the postdoctoral psychoanalytic training clinic at New York University, he could even harbor hope that it would get published. In his editorial, Shatan described what came to be called post-traumatic stress disorder, and told how he had noticed these symptoms in the Vietnam veterans he and his colleagues had been seeing in "group rap" sessions Shatan, ; a.
One of these colleagues that Shatan referred to was Robert Lifton. Lifton was an ardent antiwar activist who had served in Korea as a military psychiatrist and had already studied and written about the survivors of Hiroshima Lifton, Unlike most of her colleagues at the time, Haley recognized that many of her patients who had served in Vietnam, were being misdiagnosed as paranoid schizophrenics or character disorders because mental health professionals were failing to recognize the symptoms related to combat.
But she knew them. She had heard stories of trauma and wartime atrocities from the time she was a little girl and she had personally experienced the long-term impact of war on her father's behavior. What other colleagues found unbelievable, she found entirely realistic. When she met a Vietnam veteran who claimed to have been involved in the massacre of a village called My Lai, she believed him.
It was through Haley that Lifton met and interviewed that soldier Scott, In January , Lifton testified to a Senate subcommittee about the brutalization of GIs in Vietnam, a brutalization that he believed "made massacres like My Lai inevitable" Lifton, , p. In April , the U. Within days, the Ohio National Guard fired into a crowd at Kent State, killing four students and wounding nine others. Chaim Shatan had previously arranged for Lifton to speak at N. Many people came who were not students, including some Vietnam veterans who were members of the V.
Scott, The rap groups in New York evolved from this meeting and from correspondence and phone calls between Jan Crumb, then president of the Vietnam Veterans Against the War, and Lifton, beginning in November, Lifton, When the clinicians sat down with Jan Crumb and several others from V. Lifton suggested they form more regular rap groups with some professional involvement.
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With the support of the chairman of the psychoanalytic training program at N. He urged them to help, telling them that "this is an opportunity to apply our professional expertise and anti-war sentiments to help some of those Americans who have suffered most from the war Shatan, He outlined for them three theoretical questions that he believed needed to be answered.
Can we clarify the psychodynamics of war atrocities and demonstrate how they grow organically out of modern combat training? What is happening in the group process experience between veterans and professionals? The enticements worked. Within five days, his memo had drawn forty volunteers. A panel of professional psychological and psychiatric colleagues in the New York area was formed. These clinicians participated in the groups until at least Shatan, They called themselves "professionals" rather than "therapists" because they "had a sense of groping toward, or perhaps being caught up in, a new group form.
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Though far from clear about exactly what that form would be, we found ourselves responding to the general atmosphere by stressing informality and avoiding a medical model" Lifton, , p. Word got out to the Vietnam vets through word of mouth, churches, and some media coverage and they started to come. In , Shatan and Peter Bourne testified at the court martial of a Marine POW who was being charged with desertion, though he clearly suffered from traumatic stress.
The papers written by Bourne and published in and about war neurosis were ignored. The refusal to see the damage that had been done to these men motivated Shatan even further.
The response to Shatan's op-ed article was overwhelming. He heard from over 1, rap groups from around the country as well as student health and financial aid offices on many campuses, and even veterans in prison. Groups had already been meeting informally with psychiatrists in Philadelphia, Atlanta, and Boston Shatan, All were functioning outside of the established VA services either because they were past the two-year limit for service-connected disabilities or because they found the traditional service, geared to World War II veterans, hostile to them and unwilling to meet their needs Scott, There was at this time, tremendous hostility towards the returning Vietnam veterans, particularly those who had become disillusioned with the war.
And the hostility came from the left and the right sides of the political spectrum. He reported that a Minnesota American Legion post excluded Vietnam vets because they had lost the war. Meanwhile, there were antiwar activists and pacifists calling the veterans "baby-killers" Shatan, Even the military victimized the vets as they were leaving the war through the practice of giving "bad discharge numbers". According to a discreet coding system, numbers were entered on discharge papers that identified veterans who had been seen as "troublemakers" while in the service, and then these codes were distributed to employers and personnel officers.
In the media, especially television, the stigmatization was furthered by the portrayal of Vietnam veterans as dangerous and psychotic freaks, murderers and rapists Leventman, In , Leventman, citing an earlier article of his own said, "nothing reflects so much of what is wrong with American society as its treatment of Vietnam veterans. This CBO report examines the pressures on the federal budget by presenting the agency's projections of federal spending and revenues over the coming decades. NOTE: To correct errors in projections of how the growth of federal debt would reduce, or crowd out, private investment and thereby lower gross domestic product in the United States, Figures and and related text were revised on August 3, The changes affect pages 19 through 22 in the pdf of the entire document.
The summary was not affected. Recently, the federal government has been recording the largest budget deficits, as a share of the economy, since the end of World War II. As a result of those deficits, the amount of federal debt held by the public has surged. At the end of , that debt equaled 40 percent of the nation's annual economic output as measured by gross domestic product, or GDP , a little above the year average of 36 percent. Since then, large budget deficits have caused debt held by the public to shoot upward; the Congressional Budget Office CBO projects that federal debt will reach 62 percent of GDP by the end of this year--the highest percentage since shortly after World War II.
The sharp rise in debt stems partly from lower tax revenues and higher federal spending related to the recent severe recession and turmoil in financial markets. However, the growing debt also reflects an imbalance between spending and revenues that predated those economic developments. As the economy recovers and the policies adopted to counteract the recession and the financial turmoil phase out, budget deficits will probably decline markedly in the next few years. But over the long term, the budget outlook is daunting.
The retirement of the baby-boom generation portends a significant and sustained increase in the share of the population receiving benefits from Social Security, Medicare, and Medicaid. Moreover, per capita spending for health care is likely to continue rising faster than spending per person on other goods and services for many years although the magnitude of that gap is very uncertain. Without significant changes in government policy, those factors will boost federal outlays sharply relative to GDP in coming decades under any plausible assumptions about future trends in the economy, demographics, and health care costs.
CBO projects that if current laws do not change, federal spending on major mandatory health care programs will grow from roughly 5 percent of GDP today to about 10 percent in and will continue to increase there-after. Those projections include all of the effects of the recently enacted health care legislation, which is expected to increase federal spending in the next 10 years and for most of the following decade. By , however, that legislation will slightly reduce federal spending for health care if all of its provisions are fully implemented, CBO projects.
That reduction in the level of spending in yields lower projections of health care spending in the longer term--even though, owing to the great uncertainties involved in projecting such spending many decades in the future, enactment of the legislation did not cause CBO to change its estimates of longer-term growth rates for spending on the government's health care programs.
Under current law, spending on Social Security is also projected to rise over time as a share of GDP, albeit much less dramatically.