Racist comments, stressors caused veteran with PTSD to repeatedly relapse

PORT HAWKESBURY: Last week, two military psychiatrists explained for the first time, what personal care retired Cpl. Lionel Desmond received in the health care system of the military prior to his medical discharge in 2015.

On Feb. 23, the Desmond Fatality Inquiry heard from Dr. Vinod Joshi, the doctor who diagnosed Desmond with complex post-traumatic stress disorder (PTSD). Joshi explained after the soldier returned home in 2007, Desmond would go without treatment for four years, until he first met with him in 2011.

“He reports a change in his personality, not able to go out of house, not able to go into crowded places such as malls,” Joshi’s initial assessment read. “He is isolating himself and has lost motivation or interest to contact family.”

Joshi explained Desmond’s symptoms included suicidal thoughts, but suggested he didn’t display signs of psychosis, or any plans to actually kill himself or hurt others.

He testified despite some success after three years of therapy, Desmond would often relapse when stressors, such as nightmares and flashbacks of traumatic events while serving as an infantryman, would act as triggers.

“Cpl. Desmond was making slow progress, but that was impeded by some of the stressors that were going on in his life,” Joshi said. “It appeared that any major psychosocial stressors (were) making his symptoms worse.”

A treatment plan was created for Desmond by the mental health team at Gagetown, N.B., that incorporated medication, group therapy and individual psychotherapy, and he would see Joshi once a month, while he saw his psychologist weekly.

The military considered having Desmond return to regular duty in 2013, but Joshi explained a major relapse in the autumn of that year happened when Desmond was the subject of racial comments at his workplace.

“He asked his friend to take hold of the weapon, and when the incident subsided and he started to feel better, he must have got it back,” Joshi said. “I took it as a sign of being in control, rather than losing control.”

However, Joshi testified that it was clear in 2014 Desmond’s long-term diagnosis was not good and he wouldn’t be able to carry out full duties as a soldier.

Wendy Rodgers, the psychologist who treated Desmond alongside Joshi, testified on Feb. 24 she would have picked up on warning signs about domestic violence or abusive behaviour while he was being treated for PTSD and depression, but she didn’t detect any.

“I was deeply, deeply shocked, particularly that he killed his daughter, because he, he, loved that little girl,” Rodgers said. “There was just nothing that raised red flags for me… I would never had predicted it.”

The psychologist said in 2012, Desmond was feeling distressed following a situation in which his wife texted him asking for a divorce, but Rodgers insisted he never showed any kind of anger towards her.

“He never spoke about his wife in a derogatory manner,” she said. “It was like an indifference.”

When Rodgers first met Desmond, she recalled he was very depressed, he spoke slowly and didn’t show much emotion. As a result, she said she encouraged him to use prolonged exposure therapy. The practice involves patients making audio recordings of themselves recounting traumatic memories to replay and help with their symptoms, she said, noting Desmond spoke about being overcome with revulsion when he found the partial remains of an enemy soldier.

“It was a very horrific sight. It was one of the things that haunted him,” Rodgers said. “As the distress goes down, the person is better able to think straight.”

She testified Desmond wanted to return to work, but turned down the opportunity in 2012 because he wanted to be present as a father in Aaliyah’s life.

Desmond finished therapy with Rogers in February 2013, in which she confirmed that his depression had changed from moderate to mild, falling to a 27 on the clinical assessment scale from a 60, and that his PTSD symptoms had subsided.

In September 2013, four months after being the target of racial comments at work, Desmond contacted Rodgers advising her he couldn’t stop thinking about the incident, as it was causing him a lot of stress and he was worried he may hurt someone.

Both Joshi and Rodgers offered insight on what services were available to soldiers while they’re serving in the military, which includes the Operational Trauma and Stress Support Clinic at CFB Gagetown.

The clinic is now supported by five psychologists, three psychiatrists, clinical social workers, addictions counsellors and mental health nurses.

When Rodgers was asked if she had any recommendations in preventing PTSD in soldiers who see combat, she advised there is only so much that can be done to prepare people for what they will experience.

“But I don’t know that anything can ever prepare someone for seeing a dismembered body covered in flies,” she said. “It’s hardwired into us to feel disgust and horror. Emotionally, existentially, you can read about it in a novel, you can see a video about it, but it’s pretty difficult when you’re faced with it.”