all the organizations that are training them and providing comfort, 10 years from now the dog will be dead and the organization will be disbanded. i wonder what would happen then. i did not know what i was vice and i was handling the suicide issue that all the drugs we prescribed for posttraumatic stress, none were brought to market to treat posttraumatic stress. they are off label. that is a doctor making a determination that they will repurpose that drug based on their professional experience that they believe it will help control your symptoms. that is a good thing in many cases, but a bad thing in others.

many of these drugs affect people in different ways. one of the biggest issues i had in the military was -- i think you will hear about two treatments that quite frankly take the dedication of time. they are not easy to do. they take time. when an rbu says to clear somebody out of your office, we are finding in the military -- when you go to the doctor, they have a business case that says based on me having high cholesterol, the doctor's have a period of time to clear me out of his office. if he tells me about all the things i can do to lower my cholesterol and takes up 20 minutes. explains lifestyle changes. and he says come back in 90 days and we will see if it is down.

somebody else goes into the doctor and the doctor says, you have high cholesterol, i will write you a prescription. he first gets paid less than the second, even though the second review out in two minutes, giving you your prescription. he performed another service. he charges more. the system charges more. we were seeing that in the military. we were seeing polypharmacy because that was easier than in every instance to do the treatments you will hear about today. and with that is kind of a introduction to the two speakers. i want to close by telling you the following.

anybody who believes it is just this generation of warriors that has this problem is really mistaken. posttraumatic stress and dramatic brain injury have been around since mankind created war. i often recommend to audiences, if you have not seen the hbo special called war-torn, i recommend you see it. it is about an hour and 10 minutes long. watch the opening. they reconstruct the life of a civil war veteran from pennsylvania. he went into the army and killed himself after three years in the union army. he went hunting with his friends and killed himself. he had what everyone would agree was posttraumatic stress. he told the story in letters he sent home. the other thing i would tell you is to take a look at the interview they do with the 14

world war ii veterans. they explain how they came back from world war ii with poster medic stress. they were afraid to tell anybody about it. they lived with this their entire lives. this has been around for ever. we are now shining a light on it. which is good. in a lot of ways, is it that. the general perception of the public is anyone who is deployed has posttraumatic stress. the majority of those do not. please don't leave here with the misconception that this is because of this generation of warriors. this has been around forever. we are shining a light on it. we will call with better diagnoses and treatment soon. i will stop right here because i see the congressmen is in here. i know when it is my time. thank you very much. [applause]

>> thank you. you could have had a couple more minutes. before i go on, i want to acknowledge our partner. they are one of the most enlightened private philanthropic foundations. with influence from the world. among other things, they not only fund neuroscience activities. public understanding. they are responsible for the core of something called brain awareness week. the european dana alliance on brain initiatives. very wonderful partner for us. not only in this activity, but in some neuroscience and society presentations we do. thank you.

with that, it is my great pleasure to introduce our other partner in these activities. one of my favorite neuroscientists. almost neuroscientists by now. a member of the house of representatives. one of the most important places to be from. he is among other things the ranking minority member -- the department of energy. the national institute of science and technology. an array of other important science activities. he is among other things one of the greatest supporters of science in this country. he is the guy who had the idea

for a brain initiative. i love that about him. with great leisure, i give you chaka fatah. [applause] >> first of all, let me thank each of you for coming. this is an important -- and i hope you will find it enlightening -- briefing on one of the major challenges we face. there are hundreds, well over 500 related diseases and disorders. but posttraumatic stress is a challenge that is at the forefront of the issues. i know you have heard from the general.

a significant percentage. 40% of our injured soldiers over this period our nation has been at war. these injuries are posttraumatic stress. whether it is in turn on the work one mind has focused on. i know you have heard a little bit about it today. i want to make room for our other guest. i just want to say a few things. one is, i want to thank the dana foundation and alan for that introduction. these briefings have helped build the kind of consensus we need in the congress. we had the largest increase of any of the science accounts in the neuroscience space. taking the national science foundation investment in this area for the next fiscal year, it will be over $500 million. over the last couple weeks, a

lot has happened. i met with the president of the european union. interact with the head of the israeli brain technology effort. a lot of international activity in the space. here in this country, we are starting to find our footing on the fact that we have to make spending and investment decisions that are going to advance the science. in part, in order to do this, congress has to understand the state of the science. that is what the working group is about. the brain initiative has the important -- it is part and parcel of what we need to do. this briefing, like the others, is about having us build a currency for knowledge. so that we can help move this bipartisan consensus forward in a way in which we can make a

contribution. i will stop there. i visited the national intrepid center. i have been around the country looking at the activities in a variety of labs. i am convinced we are at a tipping point and we can make progress. what we need to do is to understand that. as allen said in his editorial, we need to seize the neuroscience moment. i will stop there and let you continue. [applause] >> as a neuroscientist, i have to make the comment that the congressmen had the insight that

the brain initiatives are being coordinated around the world. it is an important milestone for narrow science that it would be corrugated. the next speaker is dr. kathleen. from the university of cincinnati. she is a professor of psychiatry and behavioral neuroscience. i hope you got programs because the bios are there. >> good afternoon. thank you very much for letting me give an overview. this is one of the two therapies that the institute of medicine and international guidelines have given to as being best practices for the treatment of ptsd. i think is important we dispel

some of the myths that they are not treatable and it is a lifetime disorder. a lot of us go through, throughout our lives, whether it be car accidents, the sudden death of a loved one. we don't expect to be miserable for our lives. that there's something about being a warrior that makes people think this is something they were suffer with permanently. dramatic stress is true medic stress. once it rises to a significant level that the person is

impaired by it, we have to understand we can then treat them and help them get better. with cognitive processing therapy, we have one of the treatments. this therapy is quite old. which is scary, thinking how little we know about it in society at large. we have used it in china for victims of the earthquake. we used it in the world trade center for the survivors who did the cleanup after 9/11. dispelling the myth this is just about warriors. i want to take a second to talk about the seriousness behind it. we all organize our thoughts. the governing usable of how we interact with the world. your schema guides what you do. it guided whether you chose to drink water or diet coke. those were rules. where did they come from? did they come from your doctor

or nutritionist? you have schemas and rules that guide what you're doing in your lives. those are developed through interactions with your peers, your parents come your religion. the military. we often function -- if i go out and do good, good will come towards me. but there is a small problem with that. what happens when a bad event happens to someone who thinks they have been good? what happens when you are the officer in the unit and your best friend has been killed? what do i do? i must have done something wrong. by doing that something wrong, i caused his death. now i will suffer for it. what we find as they completely change their schemas about the world.

it becomes not just, i did something wrong about johnny. if i am in charge of things, i will make mistakes. things will always go wrong. i can't trust my gut. the world is not safe anymore. i can't even trust other people. i can't get close to people because they will die. we see these alterations in people's cognitions. the circle of life gets smaller. they don't go out. what happens? depression. often we seek substance abuse. now we have people with multiple until health disorders. if we treated the initial posttraumatic stress, the rest of it would not have happened. you see the risks for suicide

and other things going up. what does ctp look like? it is simple. it started out as a therapy. slow them down enough to understand what is ptsd and what does it look like? talk about how you have been impacted. what are you telling yourself about this event having happened to you? then we asked them to write about the trauma. people said, i am not going to therapy because you will make me talk about the trauma. how many times do i go to the general saying, special forces will come into my office and say, i cannot talk about the trauma because i signed a statement saying i would not. in cognitive processing therapy, we have shown it works well

without ever telling the full trauma story. there is no reason for not getting help if you feel you cannot tell your story. you can get better without it by focusing on what it means to you. not what happened. that's the critical difference. we begin to go to challenging these assumptions. let's look at whatever you are telling yourself. challenge yourself. i teach you to be a better therapist for you than i could ever be. we move them forward into the last phase. we talk about the five areas that are critical in terms of post traumatic stress. power control, self-esteem, and

intimacy. we asked them to revisit the impact. without this was a nice, perfect package. what we begin to see is, maybe not. some people may be needled less. some people need a little more. by the looking at these two therapies, and i don't mean to steal your thunder, but we have looked at these treatments five plus years later. they got better and stayed better. let's talk about, how much do they need. it is not even 12 sessions. the majority of people, when we look at who got better when and stop forcing them, because it was a research's teddy and you will do 12 sessions, let's look at how soon you will get better. guess what? people were getting better in eight-nine sessions.

that is all we are asking. if you need a few more, ok. let's take it up to 15 or 17 sessions. 18 sessions of therapy compared to a lifetime of distress could mean it is worth it. the hard part is they have to be willing to do the work. let me mention veterans. can it work for veterans? tenet work in vietnam veterans? -- can it work in vietnam veterans? there's nothing to suggest we can use these therapies to make them better. this is treatment as usual and non-evidence-based. it is compared with using this treatment.

look at it. it we asked them to do this, they did much better. i would like to talk about treating folks with tbi. they cannot do posttraumatic stress were. maybe it is to write method. we admitted patients into the program with both mild and severe tbi. they did fantastically well. those with low and severe tbi did better in cognitive therapy than those who were martyred. these gentlemen knew that they had a problem and were invested in working through their problems and getting matter -- better in their therapy. he a penetrating blast injury that really shredded most of his face and also took his legs from him.

he was addicted to pain pills. the time he was done with the therapist, he no longer had ptsd. he lost his leg seven months later and still do not have ptsd. we have been in contact with him two years since. even after everything this guy went through. you have got a severe tbi in his history. the last thing i look to talk about is because i know we need time for the presentation, what are we doing about it? we have a therapy that works. what are we going to get it out there? we are rolling it out. the worst thing you can do is train someone and expect them to go out and remember how to do it for five or six months later. you have to give them a monthly recent consultation with an

expert who can help them when those difficulties walked into the door, how do i work with the individual and stay true to the this model. we are doing this ongoing training of trainers in this ongoing training of your to make sure we can provide this in lots of settings. we are going to do an online training to look at online training. we can create more trainers very quickly and have them continue online and interactive ways to maintain their training capacity so we can have more people out there making sure therapists are available at all times to anyone in the va the department of defense. we do need to address ptsd there as well. does it work? i want to point out these

scores. these are the first two cases that there is ever saw. these are looking at people who are vietnam veterans, and people who are young. the improvements are the same as what we saw in the trials. it shows is that if you teach a therapist have to do it well and give them good consultation, out of the gate, they can be an effective therapist for treating posttraumatic stress in a multitude of settings where there be an inpatient or an out patient. in addition, i trained numerous dod clinicians to use this downrange. have used this and afghanistan and iraq and in five sessions in the span of about two weeks to get someone functioning. one of my favorite stories of a marine who spoke to me in my program, he wanted to stay in

the military, they're able to get him out to me that we treated his posttraumatic stress and sign the worn affidavit saying he did not have ptsd. they took it. he was at home for a long weekend and spent three days back to germany. he is still in the marines today and functioning fully as a warrior. that is the clear he wanted and he did not have ptsd. it is a life debilitating event only if we allow it to be. we could get them to continue on the left projector they want. whether that is the military or any other avenue. i would like to close out equity on the final figures of comparing the different types of

clinicians who went through that treatment. men and women can be treated equally well. all of them fight effectively in terms of the outcome. again, we took inventory because we know depression is high with stress and to treat it equally well along with the posttraumatic stress. where are we going? we need to keep doing work on group and individual hairpiece. -- therapies. we are also doing a lot of work comparing the therapy of prolonged exposure. we have 17 sites studies. that way we can get person specific item recommendation

when someone is coming in. based on who you are what you are saying, and this is the best fit for you. we're are looking at severe mental illness. some are schizophrenic. some are bipolar and manic. when they need extra help, we're looking at that. it is beginning to show that they did well. they are doing really well in those studies. we are also looking at other countries. we have there suspected not even have a college degree learn how to do the therapy and doing quite effectively by giving the training and consultation. going to people's home and meeting with their iphones and

ipods and being able to work with them instead of dragging them into a clinic somewhere where they feel very underserved or perhaps isolated but looking at all of these people that do not look like them. i will be ready for questions later. thank you. [applause] >> that data is tremendously impressive. i hope everyone is storing those up. there are programs and studies [indiscernible] >> thank you. i'm delighted to be here today come especially since i started as a young person on capitol hill as an interim and then legislative assistant before decided to go to grad school. be careful. [laughter] ok. let's see. i'm going to start by providing you with context.

why wasn't it used for vietnam's? i think it is important to understand the context that it will inform how we go forward here it we have treatments, but it is not disseminated and used as white as they could be. when i was a graduate student about 25 years ago, there were no evidence these treatments. i was handed a file about that large and it was a ptsd patient, a woman with a horrible experience of witnessing her former husband murder her boyfriend.

we didn't know how to treat her. i happen be doing a rotation on the burn center where there are high rates. i agreed to take the patient. i can tell you she would be treated much differently today than she was then. i happened to be lucky because i had a supervisor that was sort of on the right track. i will and by talking about using technology in virtual reality forms and show you a couple of videos. so, why did it work for you and not me? >> [no audio] >> i'm pressing the arrow. huh? well, they're fixing it. maybe someone can come up and show me. what i'm going to do is talk

about like exposure therapy and who it is for and what system of care is delivered in an why more people are not getting it. ok. there we go. well, they are figuring that out. i will fast forward and start this story. september 10, 2001. where were we? about a year before that, a major component of exposure therapy -- ok. yeah? ok. fast forward. we can skip that.

there we go. where were we then? there was plenty may evidence for one evidence-based treatment was prolonged exposure therapy and one fda approved medication of zoloft. the expert consensus guidelines had first been published a year and a half before recommending this treatment. can we go back once like? -- one slide? who is very new and psychiatry. our education for the point has been pretty much dominated by theory and other theories, that there wasn't an ethicist. when i started using the term that i wanted to start an

evidence-based, treatment, people kind of looked at me like i had three heads. you go forward. what is this evidence-based mean? and science in general, we're talking about treatment that has been steady and is the gold standard. it would be a randomized controlled trial comparing different treatments with different trauma populations and showing that they are effect to. the results are assessed by reliable and valid measures. they precluded that there was one psychotherapy and there are two forms of it. the cognitive process and prolonged exposure therapy or various exposure therapies that i will talk about. the evidence was sufficient to preclude that these treatments were hit in treating patients.

have it in the back of your mind. why are we not using it more? the evidence is a cross. we have at least 27 randomized trials across multiple trauma populations. seven veterans, six female assault survivors, refugees, earthquake, and the world trade center. next slide. again, i do not want to belabor the point too much. i have one example here of the united kingdom also concluded that exposure therapy were in effect it treatment. there is a laundry list of organizations around the world that have drawn this conclusion and are respected. ok. i will talk a little bit about what exposure therapy is delivered in a virtual reality

and i will talk a little bit about -- i will show you a video and talk about what i think some of the obstacles are. that is fairly important in your role as public policy here on the hill. this is also a very old treatment. goes back to at least freud if not before. and guessing most everyone in sight -- psych 101. you can talk about your feelings and thoughts and situations related to the event. we have a schematic of a person. they are going to be shocked. they will also be shown a light bulb at the same time.

it is a neutral stimulus. they shouldn't be scared when around my balls. certainly it is adversative. what happens is. have a paradigm. you care -- pair the blast with the light and you take away the aversive stimuli. there is a conditioned cue to fear. when you see the light, you will jump. next slide. keep going. what do we do in exposure therapy? it sounds like the treatment is unpleasant. you probably need to rename that treatment. it is extension training. we will take our patients and

asked them to come in. we do need to talk about the trauma. we asked them to go over our trauma as if it were happening again. over and over again until they have habituated to it. until all of those cues no longer create fear. it doesn't take as long as one might think. a typical trial isabel 12-15 sessions. a study showing that people get better but many fewer exceptions. however, because part of having ptsd is avoiding your trauma, a lot of people have difficulty engaging in it. i think we can probably skip this. you can make the point that neutral situations in real life

become associated with fear. most of us are not fearing about walking down a stairwell unless you were escaping at the world trade center not knowing what was at the bottom or whether you'd be able to get out and where your loved ones were good stairwells are no longer neutral. psychologist and psychiatrist would often use a technique for relaxing patients in which they have the walk on the stairs and close their eyes and gradually imagine at the end of that walk there will be more relaxed and going to a happy place. you cannot do that in new york without asking some if they were at the world trade center. they might be introducing their fear. the way we think about

posttraumatic stress is that it is a disorder of fear. learned avoidance is a big part of it. a cousin of ptsd is phobia. whether you are at the world trade center were served as a warrior or in a car accident, there is a common set of features. we learn to fear what the traumatic event was and unlike -- you generalize it. it means that we come back from whatever the situation was ever likely to be afraid of flying and going into bridges and tunnels. we are likely to not want to listen about bad things. there are a few cues and it leads to what the doctor is talking earlier that the patient

site -- start to narrow the world more and more. they do not want to go out to dinner with their wives because they are afraid that the noise rockers them. they are hyper aroused. there weren't something bad will happen. they feel like they're back is against the wall. what is happening there is a their brain is still processing their trauma and telling them something bad is going to happen. they are in this mode and are looking for something bad to happen. next slide. go back really quick. you were going to see a slide that said that the fear response is hardwired.

much of what happens with ptsd is the amygdala -- we don't have time to go into that. i want to make the point that there is a lot of preclinical evidence from neuroscience outlining the fiercer country in the brain. it helps us with available treatment, but will also help us going forward to develop a cure. it is not a word used in psychiatry much, that we have changed the thinking there to be more hopeful. as i said, there is a lot of evidence emerging from -- that would suggest that would be sooner than we think. let me see if i can remember what the next slide is.

it is still going back to the way we do mental illness or psychiatry. there are a lot of people who think that they can bootstrap themselves that they can get every -- over on their own and what have you. it is not a sign of a character failing. it is a condition that is eminently treatable. ok. what does exposure therapy accomplish? we help the patient process the memory in such a way that they can reorganize it and understand it is something that happened in the past that is not happening again and then we treat them to go forward and have dinner with their spouse or significant other or whomever on a saturday night. we go over what happened as if it were happening again.

this is the hard part for patients. let me get them to engage, based a. they get better and very -- and better. i was treating a high level member of the nypd not long ago. i point that out because 10 years after the fact, the officers whether they are police officers or firefighters or soldiers, we had a site at cornell and they came down to see us because we're not related to the occupational department. where i'm going with this is this man was very involved in the world trade center effort and coordinated things that they are keeping the city safe after. he ended up divorced.

he left the police department. this is a common story. i'm not saying this about any one particular individual. the point is that he got better. but he said to me afterwards was, ge, i wish i knew about this sooner. why wasn't this offered to me didn't think i could get better 10 years later, but i did. ok. that is the emotional processing. i will make this point and i will show you the video. exposure therapy is to. there is across, population -- there is a trauma population. 9/11 is still a public health problem. many stub posttraumatic stress disorder. it is treatable, but it doesn't go away unless you get

treatment. ok. i'm going to move sideways just a little bit. imagine the exposure therapy requires you be telling your trauma as if it were happening again and generating it from your imagination. we have sort of a conundrum. how to get people to engage? following 9/11, we understood that people -- we would offer them exposure therapy and medication as necessary, but we also knew it wasn't perfect. at that point we had much less knowledge. we asked, what could we do to enhance the experience in such a way that people could engage in the treatment more easily? you think about the day-to-day experience. is the new date thinking, but you are also apprehending the world in a multi sensory dimension.

why not try to create virtual reality simulation? there had been a case published by some unknowns of taking vietnam vets who had failed if you will ultimately treatments over many years and showing that they could accretive reduction -- achieve reduction. i will jump forward now. feeding backing -- piggybacking on her work and my work to get the forms of treatment, we now have a multi site clinical trial going on in comparing the virtual reality. next slide please. you can see at this point we now have -- when i started with the world trade center, it cost about three $5,000 when he had a running on a workstation. it was a limited program. i think we are all more interested in -- today we have

two scenarios. there was a city seen. we could only have one on patrol and one convoy. as a couple of days ago, my colleagues launched a version with 14 different scenarios, including scenarios which is a highly specific form of trauma. you can see here in what we do is we don't use all of the available elements. when we undergo trauma, we learn cues to the fear. a common one would be a flyover. driving in a convoy. if you go to the next slide this makes the point where users virtual reality. keep going. that is the virtual world. keep going. there we are. this is going to show a young

man coming back from iraq in 2009. he received virtual reality tree and. go to the next one please. there we go. they talk about the treatment and shows how they used it. and i'll talk about some of the obstacles. would you like me to help you? >> [indiscernible]

it killed a 16 year old boy and his father. i have a son that age. it struck home. i went home and i do not think i noticed i had a problem. my wife would tell you that you never smiled or talk as much. we were at walmart. can you hold this for me? there are like 50 kinds of toilet paper. i couldn't make a decision. i almost had a nervous breakdown at walmart. it frazzled me. it is so simple.

it was a hard decision to make. i talked to psychiatrist. i do not want to hear that. the classic symptoms. these guys are kidding me. it is the last thing i wanted to hear. sessions are 30 minutes to an hour. put the goggles on or the headphones on. i grabbed the controller and would go on patrol. you can see the doctor, but can hear him.

that intermittent intervals, you'll hear explosions and gunfire. it is tough. you spend so much time trying to avoid thinking about your deployment and they're dredging up memories that you try to avoid at all costs. it is difficult. i think it was a great idea for them to put it in that format. >> [inaudible] >> this shows you what we do is for patients who are reluctant to engage in treatment and it is still an empirical question. ours is one of the major ones and there's another one up in pacific west.

ours involves a side of new york where veterans of the national guard and active duty can go. in d.c. and the va in long beach. we can see how the treatments do with active duty as well as veterans. you can keep going. there is an evidence base for the treatment for both forms of exposure therapy. it is not clear you have the treatment will fare with different trauma populations. when guests would be this form of treatment homework well. you can sort of bypass or willful avoidance of your problems and all of the stimuli that you need to call off your

cues to fear and process your experience and get better mastered and move on. it is available in the virtual world. i do not have much time left. i started out by showing you that there is pervasive evidence of multiple governor bodies governmental organizations that have precluded that these treatments are affect did. -- affective. why don't more people get them? i want to point out that there are myths. engaging them with the memory is cruel. we shouldn't do it. people are living with this symptom. when you least expect it, you have something pop into your mind that is related to your

trauma. we're not asking people to do something that the brain is not already doing. we are introducing -- it could be done across all trauma said not just some that are like a car accident. they continue to confront traumas right here and are warriors and veterans. keep going. here is the one i want to and on. i think some of the major problems we're having have to do with our systems of health care delivery. there are multiple in prejudice. during geographical -- there aren't geographical impediments. i cannot practice in new jersey because i don't have a license. we could deliver the treatment using skype or other forms of technology, but you can. with the missed informed consumers and health care providers and the stigma and the prejudice -- keep going. ok.

what it shows is i happen to be here in town about four or five years ago. there is a huge pink ribbon hanging from the back of the white house. wouldn't it be great if we had something similar for ptsd? they get behind breast cancer. years ago that was not the case. do it for our warriors. i think my point is that i think it will take embracing by our leadership that there is stigma. i know we are at the tipping point. we have to keep pushing that method. i think that will make a huge

difference. make sure another veteran doesn't lose his family. thank you. [applause] >> if the panelists would take a seat, use the microphones. say who you are. you remember what a question is. >> [inaudible] >> we all do.

i have a greater appreciation. there has been this range of studies that have come out showing that young people being raised in some of the more challenging communities in our country -- as if they lived in a war zone. gunshots and all of that at tidbit he and witnessing that violence -- gunshots and all of that and witnessing that violence. we have seen a number of studies show kids in our cities have a higher stress and kids tested in war zones in terms of their sense of trauma. >> thousands of soldiers have been diagnosed with traumatic ring injury since the beginning of the third team year war. americans have traumatic ring injury every single year. 3.4 million.

it is hard to estimate. as much as a percent will suffer from posttraumatic stress at some time in their life. these are huge problems not just for the military, but civilian society as a whole. >> studies show that in urban areas there is often people introduced to multiple traumas before reaching adulthood. >> 8% of all individuals living in the u.s. will have posttraumatic stress to sort at some point. we know one in five women will be subject to to sexual abuse. one in seven boys will be subjected to sex abuse. one in five women will be subjected to subjected to or completed rape.

neglect and abuse children result in over $20 billion in the u.s. and about $40 million in indirect costs every year due to the problems that once someone is abused, you have the welfare system and the adult court system, all of these things happen due to that assault. when you add in all of the other types of trauma, you are talking about hundreds of billions of dollars every year due to traumatic stress. it is nothing to do with the military. >> one other point. i do not have the d. that upsets a lot of people. there are two stories told. individuals who waited and try to handle it with drugs or

alcohol, that is what we see. they don't want to be told. it is the people that are not hitting help that we continue -- we will be able to understand we're going to be able to understand the biology and what happens in the brain and it will no longer be a disorder, but injury that occurs in the brain. injuries can be healed. this desire to continue to call it a disorder, i think, is a barrier to care. >> good question. these are rather different treatments. how do you know which one to use? you pick one? there is some kind of marker you can use? >> we recommend patient informed choice. you temperature people what their two options are.

he gave them an informed choice. one head-to-head study is only once in. it is one minor thing that suggested people were hired on guilt and self blame did better than more cognitive therapy. we wanted to answer that. i love feedback. >> ok. another one. ready? how much better is better? preand aw the curves of post treatment, it didn't go to zero. how much better is better? what can we hope for when these herapies are used? >> the medication, which is a drug that was repurposesed. there is a basic science showing that it enhances learning.

>> as in zero? > pretty much no symptons. in addition, as rated by an independent assessor, the patient showed no impairment on occupational or social functions. ptsd affects social behavior. when people come in for treatment they say i'm not getting along with my spouse. i'm fighting with my boss. i didn't get promoted. we showed 80% got better. we have a lot more to do. we are reaching the point where we can talk about people going into a very long-term remission. maybe not so far from now we'll be able to talk about cures as well. >> you have to understand the couple of things. hese things take time.

when you're looking at the ability to do this, you have to look at him couple of things. second, are they given the time to do it? and execute a protocol the way it is supposed to be executed. that is a huge issue that we really need to keep the potlight on. because if we don't, we get ourselves into situations that are very, very poor. that's when you get into the poly pharmacy and other things that i have seen. >> there is a tendency -- people want things quickly and it does indeed take time. >> to further answer your question, we know 70-80% will get better and stay better. that is what the study show over and over again. what does it mean?

typically, it means they don't have symptoms enough for it to be significant for the distorted. well they have some symptoms? absolutely. if you thought about loss of a loved one, yes, you will feel sad. you will have problems sleeping. a cure just means it doesn't control your life on its terms. >> ok. you have these polls types captive. seize the moment. anything you would recommend they think about doing? >> you have got to ask the question. if you therapies, why aren't there more, better known? why aren't they out and being used and why aren't people being treated? that is the question you need to be asking. i think there are some obvious reasons for that. i personally think part of it is the medical profession.

we heard today this paper was published. that paper was published. i don't believe they have the most efficient way of getting out information so that all doctors see it all the time. when i was in a war zone, if i didn't pass the information to 100% of the people in a thano second, you would come down on me if a soldier or airman or marine was ever hurt because we didn't publish information. we have to be asking ourselves the question, why does it take so long to take therapies like these and how long does it take to treat them and the rest of the population? >> if you go to see a physician for a heart transplant and they one that wasjarvik created 20 years ago in louisville, you would live about two minutes.

they should have a standard of care current with the research. why is mental health not given the same standard of care by the state and their like to practice using techniques that were created 100 years ago. that would be the question i was asking. >> i would add to that saying it is because mental health is undervalued by our society. every tuesday we have a disposition meeting and i have about 10 people that call that don't have health insurance or have medicare or medicaid but the clinicians are often not enrolled in those programs because the reimbursement makes it so that the paperwork probably surmounts the amount of payment they are going going to get and people don't enroll in he programs. it is a pervasive issue. >> a question in the back. >> we'll pretend it is a microphone. > is there a

-- inaudible] they haven't had treatment before? haven't had evaluation's before? you are guessing to getting them back to normal here and you do not know what that was. there's a bill that could introduce mental health evaluation as part of joining the service. there isn't one right now. would it be a better understanding of who they were before? would it be helpful thing? what is that like? >> i think it is help will definitely to get more context about that individual. but the important thing we have many of these measures is a norm sample. when you create a good measure, you base it on people who are healthy dose who are not so you know what it should look like across a very large norms sample. part of the problem is measures

that some samples people like to use capture such a small norm sample that you don't know what healthy looks like on that measure. that is why it is so critical that we have good assessment to be able to show that. >> if i go to the doctor after having chest pains after eating that sandwich today. he is going to take my blood, one of the first things he does. he will say you had a bad sandwich or you are having a heart attack. we do not have any blood biomarkers. we don't even -- we can't even - we haven't even accepted diagnosis. mri's are constantly being used, but not accepted by the fda. you all caused a problem up here. you got so frustrated in 2007. you said that anybody who gets a v.a. diagnosis of ptsd gets 50% disability.

it all you have to is 20 question test to ask somebody and if you look at what 50% disability means from the va, you have created my numbers that i show you some times that i think are inflated. there are some who don't know how to answer those questions and they want the disability more than they want other things. it's a small percentage. it is a real frustration for commanders. commanders are having a rough knowing who is really say and who is trying to play the game. >> we have a minute and half left. i was told we have a hard stop at 1:30. does anyone have a one and a half minute question? >> the question -- culture is changing. it is ok to get help and talk about it before the problem becomes exasperated to the point

where they might not need all of those plans. let's just go to therapy right away and start talking about what our issues were. and what their experiences were instead of feeling like that could be a black mark on their -- >> i believe they have made great strides in ending the stigma. i really do. there are many times that to testify and i was over military suicide. they are a horrible, horrible thing. we saw the suicide rate double from 2001 to 2008. it doubled, no doubt. it doubled from being half the civilian average. we were talking about 349 suicides in 2012. yet 38,000 americans committed suicide. 38,000 americans!

if that isn't a national health problem, i don't know what case. -- is. 170,000 were hospitalized. and received treatment because they failed in a suicide attempt. those are huge dollars. this town seems moved by dollars. i would think we would start to look at that in the general opulation. >> i would second it. the d.o.d. has done a great eal. i can also tell you one of the number one predictors is positive social support. someone with non-judging and non-blaming and non-shaming. environment. not why were you wearing that dress? why were you driving that car? why were you doing x, y and z. they will actually listen to

you. it we can provide that environment, you are right. >> on that optimistic note, let's thank the panel. [applause] thank you and thank you again to our partners and the foundation. congressmen, thank you for staying. >> thank you so much. pleasure to meet you. you're from philadelphia? > yes, i am. >> next, president obama in california talking about solar energy and energy-efficient buildings. after that, democrats hold a meeting discussing long-term unemployment insurance and sylvia burrwell. nominated to be the next secretary of health and human

services. tomorrow, some of the events from this year's national cable and telecommunications association conference in los angeles. including federal communications chair tom wheeler on net neutrality rules. exable tv executives scugs how innovation is impacting industry. beginning at noon eastern on -span. >> china has become, as with you we all know, the factory to the world and it sends products around the planet in a way that makes our lifestyles possible. we could not have the quality of life that we enjoy if we didn't have low-cost good and labor in china. yet in china today, the standard of living remains 1/6 of what it is in the united states in terms of per capita income. has in a source of frustration because people realize we work hard. we are participating in the

global economy. we play by the rules in some cases and yet we're not yet enjoying the quality of life that they have in the west. what i think is so interesting about this is that for most of chinese history, after all, people had no idea what life was like outside. get back to this tour of europe. chinese people can sit on a computer in a vill imagine the the middle of nowhere and have an understanding of what it feels like to live in washington, d.c.. that heightens this conflict. >> on the rising conflict between the individuals and the chinese government sunday night at 8:00 on c-span's q & a. >> on the final day of his trip in the west, president obama spoke about efficiency and climate change in a walmart in mountain view, california. he outlined federal and privacy commitments to solar inefficiency. this is about 15 minutes. [applause] >> hello. hello, everybody. hello, mountain view.

[applause] well, it is good to be in california. everybody have a seat. have a seat. this is actually my third day on the west coast. on wednesday, we went to l.a.. then we went to san diego. we are here in the bay area. i have to get back because sunday is what? >> mother's day. >> mother's day. that is a public service announcement. do not forget. [laughter] it's mother's day. i told michelle one time, how come people put so much emphasis on mother's day and father's day not so much? [laughter] she said, every day other than mother's day is father's day. [laughter] [applause] which i thought kind of quieted me down. i want to think your mayor for hosting us. [applause]

i want to thank the folks at walmart. i know this up like a typical walmart, but it is different. that is why i am here. a few years ago, you decided to put solar panels on the roof of the store. you replaced some traditional light bulbs with leds. you made refrigerated cases more efficient. you even put in a charging station for electric vehicles. those upgrades created dozens of construction jobs. they helped the store save money on energy bills. that's why i am here today. more and more companies like walmart are realizing that wasting less energy isn't just good for the planet, it is good for the business. bottom line. [applause] that means jobs.

changing the way we use energy is just one of the ways americans have been working so hard to move this country forward. in the wake of the worst financial crisis and economic crisis in generations, our businesses created over 9.2 million new jobs. the housing market that was reeling is rebounding. the auto industry that was flat lining is now booming. you have a manufacturing sector that lost 1/3 of its jobs in the 1990's is adding jobs for the first time. more than 8 million americans have signed up for health care coverage through the affordable care act. [applause] troops that were fighting two wars are coming home. and rather than create jobs in other countries, more companies are actually choosing to create jobs and invest right here in the united states of america. but we have got a long way to go

before we get to where we need to be. which is an economy where everybody who works hard, who takes responsibility, has the chance to get ahead. we have a chance to build an economy that works, not just for a few at the top, but for everybody. that is our goal. the idea that no matter who you are, what you look like, where you come from, what your last name is, if you work hard and take responsibility, you can make it in america. that starts with helping businesses create more good jobs. one of the biggest factors in bringing jobs back to america has been our commitment to american energy over the last five years. when i took office, we set out to break our dependence on foreign oil. today, america's closer to energy independence that we have been in decades. we generate more renewable energy than ever with tens of thousands of jobs to show for it.

we produce more natural gas than anyone. nearly everybody's energy bill is lower because of it. so are carbon emissions that cause climate change. we set new fuel efficiency standards for our cars and trucks so they will go twice as far on a gallon of gas by the next decade. that saves the typical family $8,000 at the pump. for the first time in 20 years, america produces more oil than we buy from other countries. we are producing for traditional becoming t we're also a leader in the source of energy for the future. we are becoming a leader in solar. the cost of solar panels have fallen 60%. solar installations have increased 500%. every four minutes, another

american home and business goes solar. every panel is pounded into place by a worker whose job cannot be shipped overseas. today, no matter where you live, or where you do business, solar is getting cheaper and easier than ever before. with more businesses and rural cooperatives and homes choosing solar, prices come down. manufacturers get more innovative. more jobs are created. last year, jobs in the solar industry increased by 20%. but we got more work to do. i want to work with congress to do it. unfortunately congress has not been as visionary on these issues as we would like. it can be frustrating. in this year of action, wherever i can go ahead and create my own opportunities for new jobs, i'm going to take it. so far, i have taken more than

20 executive actions. from launching new hubs to attracting more high-tech manufacturing jobs to america. two reforming the job training programs to make sure more americans are getting the skills they need to get the jobs that exist right now. so today, here at walmart, i want to announce a few more steps we are taking that are going to be good for job growth and the economy and we don't have to wait for congress to do. steps that generate more clean energy, waste less energy, and eave our kids and grandkids with a cleaner planet. number one, we know making buildings more energy-efficient is one of the easiest cheapest ways to create jobs, save money, and cut down on pollution that causes climate change. it can save our businesses tens of billions of dollars a year. on their energy bills. they can use that money to grow

and hire more folks. it would put construction workers back to work, installing new systems and new technology. this is what you call win-win-win. that's why three years ago, i announced the better buildings initiative. it is an initiative to improve the efficiency of the rings by 0% by the year 2020. all right we have 190 businesses and organizations that have signed on. they are cutting energy use 2.5% every year. together, they have saved the million in energy costs. we know what works. that is why i have been picking up the phone and reach out to more leaders to get them on board. today, they are stepping up. from cities, school districts, businesses, universities, you're seeing folks move on

energy first quarter si. -- efficiency. gm is pledging to increase energy efficiency and 31 plants. university of virginia is doing the same thing. cities like little rock and kansas city are replacing streetlights with more efficient leds. in walmart, you have committed to reducing energy construction -- consumption across 850 million square foot of space. that is a lot. that is enough to cover more than half the city of san francisco. taken together, this will make a difference. it's the right thing to do for the planet. the right thing to do for the bottom line. when you save the money, you can pass it back to consumers in the orm of lower prices. or you can use it to create more jobs. folks in the private sector are doing their part to create jobs and reduce pollution. and cut waste. i am making sure the federal government does its part. two years ago, i ordered $2 billion in energy upgrades for federal buildings.

today i am ordering $2 billion more over the next three years. these will create tens of thousands of construction jobs and save taxpayers tens of billions of dollars. he department of energy is putting a new set of efficiency standards in place that could save businesses billions of dollars in energy costs and cut carbon pollution. is the equivalent of taking 80 million cars off the road. i want to thank the secretary of energy and shaun donovan of hud. who are here today because they have shown extraordinary leadership on these issues. [applause] that is worth applauding. that is the first announcement. cities, schools, businesses. federal government. we will pledge to waste less energy. we have concrete strategies that we know work. second announcement is about

more americans coming together to use more clean energy. last month, i called up leaders from a range of industries and made the economic case for why solar is a good idea. and they listened. today, more than 300 organizations from home builders to affordable housing owners to companies like home depot and apple announced they are going to expand the use of solar energy, creating more jobs and cutting carbon pollution. we have public banks like connecticut's greenbank. sachse banks like goldman . we are making it easier for renewable energy companies to attract investment. we will support training at programs at community colleges that will help 50,000 workers learn the skills that solar companies are looking for. walmart already has the most installed on-site solar capacity

of any company in america. now you have announced plans to double that capacity. it is all part of your goal to buy or produce 7 billion kilowatt hours of renewable energy by 2020. something that could save walmart $1 billion a year in energy costs. we know generating more clean energy and using less dirty energy, wasting less, can be good for business and consumers. it is good for the world we leave for our children. together, the commitments we are announcing today prove there are cost-effective ways to tackle climate change and create jobs at the same time. so often, when we hear about how we are going to deal with his -- this really serious issue, people say we cannot afford to do it. it will not be good for the economy. it will be good for the economy long-term. if we don't, that will be got -- bad for the economy.

rising sea levels. drought. more wildfires, more severe storms. those are bad for the economy. we can't afford to wait. there is no reason we can't go even further than we are so far by working with states and utilities and other organizations to change the way we power our economy. climate change is a real. e have to act now. earlier this week, i issued -- or we issued a report that was years in the making. hundreds of scientists, experts, businesses. they all contributed over the course of four years. what they found was unequivocally clement change is -- climate change is not some far off problem in the future. it is happening now. it is causing hardship now. it is affecting every sector of our economy and society. more severe floods, more violent wildfires.

it is costing cities and states and businesses money. here in california, you have seen the effects firsthand. increasingly, more and more americans do. including many republicans outside of washington. so, unfortunately inside washington, we have climate eniers who shout loud. but they are wasting everybody's time on a civil debate. chimet change is a fact. we know the shift to clean energy won't happen overnight, but we have to make tough choices along the way. we know that if we do, it will save us money and create jobs over the long term. that is what walmart understands. walmart is good at counting its pennies. that's why this fight is so important. the sooner we work together to adapt the economy to our -- to this reality of climate change, the more likely it is we do

right by our kids and leave a more stable world. ultimately, that is what motivates a whole lot of us. as americans, we don't look backwards. we look forward. we don't fear the future. we seize the future. we shape it. when it comes to energy, we have a chance to shape that sector that is probably going to have more to do with how well our economy succeeds than just about any other. we are blessed when it comes to energy, but much more blessed when it comes to the innovation and dynamism and creativity of our economy. if we do our part right now to rebuild an economy in transition to a clean energy future, we will create new jobs. we will reduce our dependence on foreign oil. we will leave our children with a better america. and better future. thank you very much. god bless you.

[applause] we appreciate your leadership. thank you guys. happy mother's day, mom. >> next, democrats holding democrats holding a meeting on long-term unemployment insurance. sylvia burwell nominated to be the next secretary of health and human services. after that, the house foreign affairs committee. on the next washington journal, conservative hq discusses the tea parties influence. then federal policies that directly affect working mothers. and high school teachers talk about the advanced placement u.s. government exam and will be on the test. e-mail, facebook comments, and tweets.

>> let me be clear that i am not defending miss learner. i wanted to hear what she had to say. i want to know why she got -- did not mention the inappropriate criteria. but i will not violate amendment rights just because i want to hear what she has to say. sanctity of the fifth amendment rights for all citizens of the united states of america. >> i have never alleged that it goes to the president. i said the tea party would clearly and fairly be described as enemies or adverse to the president policy and i think

that is pretty coachable to understand. they were trying to overturn the supreme court decision and with that i yield back entered support. debate on holding lois lerner in contempt of congress for refusing to answer questions. and arguing that president obama's foreign-policy will harm national and international safety. and a look at the newly unveiled .estoration

>> house democrats met on the steps of the capitol to urge republicans to vote on extending unemployment insurance benefits. nancy pelosi says the purpose of the gathering was to listen to americans that lost their jobs and had been seeking employment for extended time. this is about 40 minutes. >> good afternoon, everyone. last week when we sent out the notice for this meeting today, it was thought that we would be there to listen to the voices of those that lost their jobs through no fault of their own.

hoping that congress would pass the extension on unemployment insurance. has already passed the senate in a bipartisan way. room in theou to a rayburn building. a republican majority told us that for the purpose of talking about unemployment insurance extension,ngine -- we no longer had access to the room. have taken to the steps of the capitol. [applause] the purpose of that meeting was fromsten to these voices the republicans have turned a deaf ear.

we want to give voice to them. it is now on the steps of the capitol. it is now my privilege to introduce one of our very .pecial guests [applause] good afternoon and thank you for the opportunity to share my story and lend my voice to the effort to restore unemployment insurance for the 2.5 million of us that have been cut off from that critical lifeline. from52 years old and i am saratoga pennsylvania.

i was laid off when my longtime job was outsourced. i have experience in my field, i hold a degree in physics and i am a proud veteran of the united states air force. despite having a competitive resume, a professional portfolio, a successful history of employment and a depth of technical and professional experience, i am looking for work. people, i gether callbacks and interviews. i have been applying for jobs in my field as well as in areas from which i have prior experience. even administrative positions. out two hundred 29 resumes for specific job

postings and had 26 interviews. still no job. my benefits ran out at the end of december when the federal emergency unemployment compensation program was allowed to expire. i was appalled to see your attempts to renew federal jobless aid callously dismissed and rejected. since then, i have been horrified to witness the delays, obstruction, and petty posturing that kept it from being restored. even as the toll continues to mount of those being abandoned. earlyy of hope finally in april of a bipartisan temporary extension is one that would be crushed if house republican leaders refused to bring it up for vote in this chamber. my husband and i are fortunate because he is still working. alone can't cover our mortgage or other necessities.

unemployment benefits were our lifeline. when they were cut off at six months, we began thinking fast. we depleted all of our savings just to make ends meet. everything that i worked for is now gone. we borrowed from my mother-in-law to make the mortgage payments for april and may, but that's it. or a new job,wal by the end of may, we are done. make theave nothing to mortgage and we will lose our home. our american dream has turned into a nightmare and we realize there are many people, through no fault of their own, that are in dire circumstances. especially those with children and no spouse's that have been suffering. congress'sause of failure to restore federal unemployment benefits.

i want you and all members of the house to hear my story and reflect on the fact that restoring federal in uc would help relieve a tremendous amount of hardship for me and millions of others. let democracy work. the time for excuses is over. [applause] this morning, there was a room available for some citizens to come to washington, their capital, their office building, their office, and tell their story. they cut us off. they tried to silence the voices that are hurting

because of republicans ignoring the pain of so many people in america. we are raising awareness today about an issue that has adversely impacted 2.5 million americans. wanted to of whom speak today in their capital. they cut off of emergency unemployment insurance was another consequence of republicans failed leadership and do-nothing agenda. as congress fails to restore insurance, another 72,000 people a week will join the ranks of those only listen to today. introduce,ppy to proud but not happy. because she has been unemployed since early last fall and lost

her unemployment insurance in mid-march. a victim of the ignoring of the people's pain by the republican leadership. thank you for being here. >> iq for the opportunity to share my story with you. i am originally from york, pennsylvania and living in fort washington, maryland. i am a hard-working young woman -- young woman with a bachelors degree in geography and a masters in administration of justice and security from the university of phoenix. was in my 60 year working as a geographic information systems tech for a contractor within the united states census bureau. ands happy and love my work

felt like i was getting somewhere and on my way. andeptember 1, my boyfriend i moved into our first apartment together. six days later, we celebrated my 30th birthday. one week after that, my world was turned upside down. with less than 24 hours notice, i was let go among with 10 others which was half of their 22 person team. told it was because the contractor had to drastically cut back under pressure from budget cuts and sequestration. i had never been unemployed before and believe me, if you haven't been unemployed, you have no idea what it's like, especially in a tough job market. first, we cut back on whenever and wherever we could. we had no thanksgiving. we had no christmas.

second, i began receiving my unemployment insurance. at least we were able to make do. airlineiend works as an food service delivery driver but they are paid so little that it was only with the ui benefits that we were able to keep up with rent payments. and i launched myself into an intense search for work all day every day. and i am still looking. my technicalh experience with a bachelors and masters degree, it wouldn't take long to find a new job. i had not a single interview in the first four months of looking. applicationser 300 out for specific job postings in places all over the east coast. and have had only a couple of interviews including one in florida that did not pan out for which i had to use my own tax refund money to pay for the travel expenses.

i have been told by recruiters that they have at least 100 qualified applicants for every open position. take much to figure out for a lot of us it will take longer than six months to find a new job. six months of unemployment benefits is all that i received. regular state unemployment ran out in march. without the support of jobless aid, i'm not only depleted my savings but have been forced to draw cash against my credit card to keep up with last month's rent and car payment. now there's only $500 left and even that is going to leave us a few hundred dollars short for the may 1 rent. car, phone, and internet that i used to search for jobs is at risk along with defaulting on

one of my student loans. i know the senate has passed a temporary compromise and it has been awaiting action in the house. i think it's the for at least 2.5 million americans that have been cut off from the spinal lifeline while we continue to look for work. this isn't about politics, it's about right and wrong. restoring unemployment insurance is the right thing to do. please don't turn your backs on us and don't let us down. thank you. [applause] back on us.n your that's what the american people are saying all over this country. i want to introduce another young man from maryland. is represented by john

delaney who is fighting for unemployment insurance. career in the army national guard and lost his job in june of 2013. a civil engineering and environmental firm. the state unemployment insurance ran out in 2014 and we need to hear his story. >> thank you for allowing me to speak today. i'm a little nervous. my name is kevin mccarthy. i'm a 38-year-old married father of two. i have two amazing teenage daughters that i love to death. i always wanted to work. i watched my mom and grandmother work hard to provide for me and my siblings. i took a job at 12 years old delivering newspapers and i kept

that for four years until i was legally allowed to work at an establishment and get paid by check. i was excited. it was great. tothe age of 17, i needed find a way to pay for college so i joined the national guard and i was proud to do so. i served for six years. much to the chagrin of my parents who were both marines. i was able to start my career in the manufacturing industry and continue that for several years working my way into the industry of construction. my career arc has always been constant, jobs in both of those and i've always gotten rave reviews from my employers. when may 20,rprise 2013, my current employer told me that my position had been eliminated because they were

having a bad year. at first, i wasn't terribly excited about it. problem sending out several resumes a week and no callbacks. it's the first time i had to as well. with those unemployment benefits, we were able to make do by cutting back on everything including christmas for my two daughters. my unemployment benefits ran out in 2014 when i received a letter.

thoughtocked because i that by then, congress would've passed it. i had to call my wife and i cried. i did not know what i was going to do. i panicked. kind of like what i'm doing right now. works, she only gets 30 hours a week and a bakery doesn't pay that much. we are barely making ends meet with a little bit of assistance from the state of maryland. ago, my oldest daughter took an extreme measure and felt like she was a burden to her family. she watched her father worked hard. how do i explain that to them? except that we are being let down by the people we elected into office.

sorry. you have no idea how soul crushing it is to listen to your daughter tell you she's a burden. i know i'm not the only family suffering. there are over two and a half million like you've heard already and it's unnecessary. this can be eliminated if democracy was allowed to work. unfortunately, petty differences are keeping that from happening. i hope that me taking the time to tell my story along with everyone else, i hope this changes some people's minds and but bring this up to vote. democracy do its job. thank you. >> kevin, thank you.

your daughter is going to be very proud of you today. you are speaking for millions of americans that have been cut off. country, foris millions of americans, their top priorities are two very simple things. a job that pays well enough to take care of their family and some assurance that their financial security would be protected. no one here would dispute that we need to be doing more to invest in our economy and create new jobs with a fair wage. we also need to extend unemployment insurance for folks that are struggling to find a new job. we're are here today because fromess needs to hear those that play by the rules, as you have heard -- they still lost their jobs and are still looking for a new one.

the senate voted last month on a bipartisan basis to extend unemployment insurance. we are appealing to republican colleagues to allow a vote on the house floor so we can restore this vital lifeline to these hard-working americans we are hearing from today. the families and children that they represent as a try to restore that portion of the american dream. i am honored to introduce kimberly chamblee. >> my name is kimberly chamblee. i am 53 years old and the college educated single parent of a 17-year-old son. working in junior high school as a paper carrier and continue to work part-time

throughout high school and college. at times working two jobs to pay for my college tuition. i started my professional career in sales and marketing in 1984 within the life science research industry. employed for the last 30 years. i have built a solid reputation and have independently supported myself and my son with this career. in june, my company reorganized and my position was eliminated. i lost health benefits for my son and myself. i unemployment insurance benefits ended as of january of 2014. i have been living off what was supposed to be my retirement savings. i do not have a pension plan to rely on when i retire. i applied for the affordable

care act and fell into the unemployed loophole. i was not eligible because i made too little money because the state of pennsylvania did for thend medicaid long-term unemployed. longer i stay unemployed, my social security benefits will also decline in my retirement. i have been aggressively looking for full-time employment. i am working with an outplacement firm. i am working with headhunters in my profession. i use linkedin, i network with other professionals. i am on many job sites on the internet. old,neither too overqualified, or companies hire from within to avoid adding headcount.

life, ifirst time in my could not pay my electric bill and have looked at pico for assistance. my 17-year-old son is on the free lunch program at school and has just been accepted on the medicaid. in time because earlier this month, he had to have emergency lung surgery that would've wiped me out. thes living and working american dream until june of 2013. what is going to happen to me these are the future? the questions that keep me up at night. where will my son and i live? how will i feed him? how will i get medical care? how will my son go to college? i am ready, willing, and able to take on a professional position

equivalent or comparable to what i was doing and earning. i have done everything right and played by the rules and i am on the brink of losing everything i have worked my entire life for. please come to some compromise to extend the unemployment benefits for hard-working americans like myself that have played according to the rules and believe in america. thank you for your time. >> you have heard some heartbreaking stories. the question is whether the republicans behind us will listen. i want to make one important point. this situation today is different than before. before has there been such

a high percentage of the unemployed who are long-term unemployed. more than one third of the unemployed in this country are long-term unemployed. before has this government cut off unemployment benefits for the long-term unemployed in this way. and they are from all walks of life. the estimate is, if this institution does not act, the number will reach 4.9 million people who will be cut off from their unemployment insurance. heart the take to heartbreaking stories. people come from all walks of life.

one of them is a resident of ohio having moved from michigan. >> thank you for giving me this time to share our story with you. old, i live in ohio, a suburb of cleveland with my wife of 15 years, stephanie, and their six wonderful children. of 2013, i was the sales manager in the flooring industry. we've been blessed to raise her children who range in age from 14 to one a half years old surrounded by wonderful friends and incredible family. both emotionalus and financial support as we have faced tumultuous times.

years of corporate sales, i cashed in our retirement to fulfill their lifelong dream of opening my own flooring and remodeling business. sales grew quickly but expenses grew faster and we ended up leveraging our house and savings to shore up the business. in 2012, after suffering a loss, we were forced to close our doors and final for bankruptcy. this was devastating to me and my family but luckily, i was able to quickly reenter corporate sales. i would need to sign a noncompete agreement. i was not in a position to negotiate so i signed the agreement with the hope that i would never have to compete because i would never lose my job and remain employed. after just nine months, my employer decided to let me go with no warning and enforced

their noncompete. no income, noith insurance, no savings, and no toal ability i knew it would take time to .ransition i've applied for nearly 200 jobs. had hopes of