Today. For the parents and grandparents, sisters and brothers of these little children, and for the families of the adults who were lost. Our hearts are broken for the parents of the survivors as well. For as blessed as they are to have their Children Home tonight, they know that their childrens innocence has been torn away from them too early. And there are no words that will ease their pain. As a country we have been through this too many times. Whether its in Elementary School in newton or a Shopping Mall in oregon or a temp el in wisconsin, or a movie these never aurora or a Street Corner in chicago, these neighborhoods are our neighborhoods. And these children are our children. And were going have to come together and take meaningful action to prevent more tragedies like this regardless of the politics. This evening michelle and i will do what i know every parent in america will do, which is have our hold our children a little tighter and well tell them that we love them. And well remind each other how deeply we love one another but there are families in connecticut who cannot do that tonight. And they need all of us right now. In the hard days to come that Community Needs us to be at our best as americans, and i will do everything in my power as president to help. Because while nothing can fill the space of a lost child or loved one, all of us can extend a hand to those in need, to remind them that we are there for them, that we are praying for them, and that the love they felt for those they lost endures not just in their memory memories but also in ours. May god bless the memory of the victims. And in the words of scripture, heal the broken hearted, and bind up their wounds. Rose flags at the white house and the capitol are flying at halfmast in recognition of one of the worst School Shootings in american history. The victims and their families are in our thoughts and prayers this evening as we air a program on a brain series about post Traumatic Stress disorder. After this break, our program on post traumatic disorder begins. Funding for charlie rose was provided by the following captioning sponsored by Rose Communications from our studios in new york city, this is charlie rose. It is estimated that one in five American Veterans in these wars suffer from severe depression or post Traumatic Stress disorder. Retired Lieutenant Colonel john o blin is one of them. He served four tours in iraq and surrounding persian gulf as well as three tours on the tours on the border of israel and egypt, awarded the bronze star, purple heart and kbrat action badge among other commendationses. He joins me tonight to talk about his life, also joining me an Extraordinary Group of scien titss, mary stein from california san diego, lisa shin from tufts university, kerry russler from emory university, joann difede from cornell and my cohost is dr. Eric kandel. A noubl lawyer yet, professor at Columbia University and a Howard Hughes medical investigator. I am pleased to have all of them here this evening at this table. Which begin as we always do talking to eric kandel. What are we doing this evening. Post Traumatic Stress disorder. This is a fascinating disorder. And it is unique in psychiatry. It is perhaps the only psychiatric disorder whose cause we really understand well. Post Traumatic Stress disorder is a response to the physical threats to the integrity of ones self or someone else. It is associated with feeling of tremendous fear and helplessness. We are privileged to have john obrien with us today who can tell us directly what its like to experience post Traumatic Stress disorder. As you pointed out hes an american hero. He just retired from being Lieutenant Colonel in the army. And served 25 years of duty including service in iraq where he first developed post Traumatic Stress disorder. Post Traumatic Stress disorder as you pointed out is no rare to the rare, its also not a recent disorder, estimate its range from 15 to 25 of troops coming back from this current war suffer from post Traumatic Stress disorder. Moreover although its only been recognized at a specific diagnostic category for about the last 30 years, post Traumatic Stress disorder has been with us since people have been going to battle. The trojan war one of the arearl wsts on w record, e heromer skroobed in the iliad took placeroyblbaro 00 bc and homer wrote t it inab 8,000 bc. There he describes how achillesib rrurte hlyt ht by the death of hisosestt friend by hector thead leer of the trojan tr a rampage in which h a raage in which he arsttod a ill people, und hector, killed him, screaming nothing matters to me now but killing, blood, and men ining aonee. Tied after to his chariot and dragged him around the grave three times. And homer points out that you not only suffer from post Traumatic Stress disorder, which is not the name he used, you suffer from this disorder if you are a victim of violence but also a perpetrator of violence. An in fact, achilles releted repeatedly had reminisces of this and bad dreams about this afterwards. American troops have been suffering from post Traumatic Stress disorder since america existed, in the war of independence, in the civil war, world war i, world war 23, all the subsequent wars. But it wasnt until the aftermath of the vietnam war because of the, you know, political unpopularity of the war that this was considered a serious diagnostic category. In 1980 the American Psychiatric association officially designated it that. But in the early days, because the evidence of post Traumatic Stress disorder comes from an individual report, people were skeptical about the reliability of its, thought this was a way of soldiers found to avoid going back to the front. They called this bad behavior and as the New York Times, which by the way seems to be calling our programs each time, last time they did pain, now they are dos post Traumatic Stress disorder, they must be watching what is happening on charlie rose. Rose they could do worse. They could do a lot worse. laughter so they pointed out that veterans from the vietnam war suffer a double hurt. First of all they have the disease, the post Traumatic Stress disorder but in addition because many of them were thought to be malingerers, bad behavior they did not get an honorable discharge. This is no longer the case. This is now considered a legitimate category and people who suffer from it are treated appropriately. And one of the reasons it is a legitimate category is because in addition to having a good clinical definition we are beginning to have some biological markers of it. We know a little bit about the genetics. So we know from imaging experiments this of what we will discuss here that there are three areas in particular that are involved in post Traumatic Stress disorder. The a mig delia, the prefrontal cortex which regulates the amigdila and the hypocampus. And hypocampus is shut off in part by post Traumatic Stress disorder. And that is thought to account for some of the misplacements of memory and distortions of memory that occurs. Also there is evidence for genetic participation in this. If you have an identical twin that has post Traumatic Stress disorder the likelihood of you getting post Traumatic Stress disorder is much greater than if you had a twin who is not identical. Post Traumatic Stress disorder doesnt simply occur as a result of war. It also occurs in civilian life. And interestingly there women are much more susceptible to post Traumatic Stress disorder than men, because they are more susceptible to sexual abuse, physical violence. But in addition to just physical brutality there are other things that can contribute to post Traumatic Stress disorder. Natural disasters, things like 9 11, hurricanes and storms can all particularly if people are in awkward situation relationship can trigger post Traumatic Stress disorder. The symptoms of post Traumatic Stress disorder in addition to helplessness have other features. Nightmares, recurrent bad ideas, bad frightening thoughts, a tendency to avoid the situation that in any way recalls it. So this is really a very painful experience. Although we have only considered this as a diagnostic category for 30 years, its amazing how much we know about the biology of this. Charles darwin realized that we convey emotions through our faces. And was very much interested in the expression of emotion. And he pointed out that emotions are amazingly conserved among different people. If u are going to llop arleveh o t ie world, they express tham see six or seven proto tipic emotions and expressive of theeam s facial features so you see, for ex ple,ssar esdn in the leftndes apiapne hss in the right. And this is prettyss universal. Not only tt,hay he realized profoundly thatis h evolutionary conservednis a ale animals this was mpcompleanimal, o rag n t even mend a a rats show ymotional responseser v milar to that of humans, an darwin chose this picre of a human beingnd a o rang a tan showing a very similar response. To emotion. And the reason this is so power sfl that many people have been influenced by darwins realization about the conservation of behavior and emotional response and used simple animals as were going to hear about this afternoon, to study post Traumatic Stress disorder which we can produce rather readily in mise and in rat its. There we can learn about the genetics of it, about the neurosystems that are involved and a masesingly we can also get some insights into treatments that could reverse it in animals that can then be applied to people. So were going to hear a number of different approaches to trying to help people with post Traumatic Stress disorders. Psycho therapy groups as well at things that have come, farmco therapy that have come out of animals. So this is really a remarkable disorder in which not only do we have a very good understanding of what causes it but were beginning to get some insight into how to treat it. So were in for a very exciting discussion. Because these are the people that have pioneered it and john is the person who has experienced it. Rose let me turn to mary stein, murray stein, give me an overnight adding to what eric said and the prevalence of it. So as dr. Kandel mentioned post Traumatic Stress disorder is very common in our military personnel who have been returning from iraq and afghanistan, and the rates, you heard, are up to one in five people with post Traumatic Stress disorder or depreltion, substance abuse, those all kind of travel together. But its also very common in civilian life so in the u. S. General population, estimates of similar around 2 to 3 of people have post Traumatic Stress disorder in their lifetime. Some people are more likely to develop ptsd because of their occupations. A lot of post Traumatic Stress disorder in firefighters, in policemen and women. And then as eric also mentioned, more ptsd in the general population in women than in men in large part because of the kinds of traumatic experiences women are often exposed to, domestic violence, sexual trauma and the like. Rose is the core here the fear, whether its from war or from civilian life, the idea of the constant fear of being assaulted . So the core is really that something life threatening has happened to profoundly change the individuals view of the world and their expectations. And a big part of it then is this ongoing fear that it could recur, it could happen again, its going to come back opinions when did you first notice it, john. When did you become aware that what you had been experiencing might be something not what everybody experiences. It doesnt suddenly happen. And i think after doing, you know, the four deployments over to that part of the world, it kind of cent up on me slowly. I first noticed maybe i was on leave, in fact. And i was in a hotel and i woke up in the corridor of the hot well no idea how i got there i was sleep walking. And i kind of put that aside. And tried to let that go. And then nightmares started to creep in. And i noticed when i kept going back after leave or another deployment, it was great. I was fine over there and i would come home. And thats when i would start to get sad. I would cry for no apparent reason. I isolated myself. And i would just stay in my apartment. And not go out. And then ultimately the symptoms did get worse to incredible boughts of and bouts of anger, for no apparent reason just getting extremely frustrated, even yelling out my apartment window because the fire trucks were too loud. And so it was an incredible. Rose what did you think was happening . I did not want to think it was ptsd. I grew up. Rose which you were familiar. Oh, yes, absolutely. But its always, its the men. You got to worry about them. Its going to happen to them. Its not going to happen to you. Im a senior officer. It cant happen to me. So i had been in long enough to know that this wasnt going to happen to mement and sure enough it did. And it didnt just go away. It didnt get better, it got worse. And i realized that i had to get out of new york city. It was too much stimulation all the time. And so i did. I moved and i moved to an island off the coast of rhode island. And that took some adjustment as well. Ill bet. Rose but prior to doing that and realizing the things that i needed to go to help, i went through the dod study that i think you could explain better as far as that medicine goes, this type of psychotherapy that helped me, incredibly. It doesnt get rid of ptsd. It helps you deal with it better, think about it more logically, process it better. And i think those tools that you learn in this program plus maybe that medication. Do you think you could explain to us a little bit about how your life has changed with therapy and whats different . Well, now i recognize that, yes, i do have ptsd. And im not embarrassed about it any longer. But it caused me to think about these things that happen. For example, not just a horrifying event that took place but it was bizarre. And that was in the republican balance as in baghdad. I was there for a meeting with the force protection colonel. And of course as usual the rockets come in. And theyre blowing up outside. And then i see smoke coming from down the hallway, a lot of smoke. And we were running down. We go in. And as soon as i enter the room i see where the smoke is coming from. Its coming from the engine of a rocket, but still its embedded in the floor of the wall and im like wow, thats and so i went further in the room to see if anybody was in there. And sure enough there were. There were two people who were dead and one woman, she was a civilian, she was literally cut in half by the rocket. And the Lieutenant Commander basically had his face taken off. And it, these are images and the smell too, the caustic odor of the rocket propellant, i can still sense it talking about it. And i can see those images. And i and right now, you know, my hearts racing now. Rose as you speak. As im speaking because, you know, i thought for sure the rocket was going to blow up. What is interesting and i gather very common is that particularly people in responsibility are reluctant to admit to themselves that theyre suffering from post Traumatic Stress disorder. And here as in all other medical disorders the earlier you get treatment, the easier it is for you to recover. How long did you wait before you started to seek treatment of any sort . I was ordered by the army to go during well, i came back and and it was part of the medical Evaluation Board process. I had had a heart attack and had four stents put in my heart. And when i came back the last time, i was in the airport and it was the classic heart attack, the crushing chest pain, sweating, nausea, pain in the arm and shortness of breath. And that caused the army to send me through an incredible physical evaluation. Well, i can understand. And a lot of that changed me too, and i they were able to push the right buttons. But even before that i was told or recommended when i came back after i think it was in 2005, i went through the line, the outprocessing line and saw a psychiatrist. And she pressed the right button. She said you should probably see stb afterwards. You probably have post Traumatic Stress disorder. Rose were you surprised . Yes, i was. I said i come from a city of 8 Million People with ptsd. And she said excowes me. I said, well, remember 9 11, yeah, you know, i watched the second plane hit. And how many other people, how many people lost loved ones there, very horrifying. And so maybe that was the beginning. But again, i couldnt bring myself to, you know, here i was a Lieutenant Colonel, you know, im in the infant ree a signed to special operations command. And it was it is not easy to admit. It is embarrassing at first, i think. Rose tell me about imaging and what were learning . Well, in the last 20 or 30 years imaging in medical science has advance advanced to the degree so that we can actually use techn