What happens when the fighting is over and it’s time to come back to civilian life? For any military personnel, this can be one of the hardest transitions that they will ever face. A normal deployment can last anywhere between 90 days to 15 months. Three to 15 months of uncertainty, three to 15 months of not seeing your family, of not being able to communicate regularly, of not even being able to tell them where you’re at.
You’re told when to get up, when to go to bed, when to eat, and you sleep when you can. You’ve done untold missions, followed orders and kept your head down.
Now you’re back.
Transitioning back to civilian life is a challenge in the best of conditions. There may be a spouse you have to reconnect with and be able to make decisions with. No more barking orders and expecting things to get done. There may be children that you have never met or ones that don’t really remember who mommy or daddy is. There are jobs to go to and bills to pay and no one to tell you when to do it. You’re simultaneously surrounded by family and yet alone.
These transitions are difficult enough, but many of our servicemen and servicewomen also come back with other issues. These are the mental health issues that we are just starting to recognize as a serious problem. Flashbacks and night terrors, isolation from a family that has had to learn to function without you there, substance use to dull the pain, and PTSD, are all common problems for those returning from combat.
Many of our service people need treatment for PTSD or other mental illnesses. Veterans that were deployed for Operations Iraqi Freedom and Enduring Freedom experience PTSD at a rate of 11-20 % and those are just the reported cases. These service members were exposed to combat scenarios, and they may have been exposed to extreme life-threatening situations, death, and destruction while on missions. We want veterans to be able to access the care that they need, but there are several unique situations that we need to take into consideration when attending to veterans.
When “Army Strong” Isn’t Enough
From the moment our veterans enter boot camp, they are broken down to be built back up into soldiers. They have entered into a “warrior culture” where strength and bravery are commended and there is no room for the weak.
You have to have your battle buddy’s six. You have to be able to perform under intense stress without losing it because lives are literally counting on it. Seeing action, being the “door-kicker”, is a revered position and being called a poge (someone in the military that doesn’t actually fight) is one of the worst insults someone could get.
So how do we get out of this mentality? How do we let our servicemen and servicewomen know that it’s okay to seek help? Most veterans don’t proactively seek help. Either they finally realize they need help or a family member realizes they need help.
- Educating veterans, friends, and family on the symptoms of PTSD. Many service members only realize there is something wrong but they aren’t sure what.
- Letting them know that it is possible to get better. If a veteran doesn’t believe the treatment will work, they are less likely to follow up and follow the advice of their therapist or counselor. It also helps when the veteran has the support of friends and family.
Many veterans will question why they are even there, thinking that they should be able to handle things on their own. After all, they made it through the actual traumatic event “just fine.” Why shouldn’t they be able to handle the memories?
The military mindset of facing hardship without complaint has been drilled into them, and it will remain a part of them even after they leave the military. It’s important to help the veteran understand the need for processing the trauma they experienced.
There’s No Room for Judgment and Don’t Pretend to Understand
“I went through something similar to that once.”
“You did what?”
Any service member can tell you that civilians will almost desperately try to connect with the veteran’s own experience. For every story, they share in a group of non-military friends they will be met with one of those comments.
The truth is unless you’ve experienced war unless you’ve lived through scenarios where you’ve seen people (maybe even close friends) die while also fighting for your own life, you don’t get it. You don’t understand and you never will.
Most vets have a ton of stories to tell. They talk about finally getting that Burger King on base. The time Jones forgot his PT belt on the way to chow. The kids they befriended. All the crappy bootleg DVDs the locals sold them. They’ll tell the funny, lighthearted, and sometimes gross-out stories but rarely the dark, dangerous, or sad ones.
That’s because there is no room for judgment. Veterans will often keep those stories locked away. There are many things that they’ve seen, smelled, tasted, or even done that they don’t even want to remember. Sometimes there is guilt, even though they did nothing wrong. An old saying goes “If you wouldn’t tell your mother or put it on the front page of the paper, you probably shouldn’t do it,” but that doesn’t take into consideration times of war and extreme choice.
Because of these reasons, finding a good therapist is essential. Reacting in horror, shock, or revulsion to the stories that these men and women have had to face will shut them down, fast. Seeing the expressions on the face of someone who was supposed to be there for them will only mirror the inner turmoil they are already facing. If they feel like they are being judged for actions or sights they had no control over they will stop sharing and therapy will go nowhere.
Veterans are There for a Reason and It’s Not to Be Thanked for Their Service
Most service members are very direct and blunt. If they show up for therapy, it is because there is a problem and they want to fix it. They don’t want any hand-holding and they certainly don’t want your pity. They know they have seen some “stuff” during the course of their “time in”, that’s why they are there.
It is important to work through the feelings that brought them there but they don’t want to feel as though they are being treated like a victim. Even if they didn’t “sign-up” to be there, most hold a certain amount of pride for their service. They didn’t sign up to be nurtured or coddled and they don’t need to be treated like children.
They represent the 7% of the population that has seen things most people couldn’t handle. Many of them have had to grow up fast as the primary age of enlistment and commissioning is 17-24. If they have served, they are by now seasoned adults.
They also don’t want or need hero worship. Many civilians, as soon as they find out someone has served, want to immediately thank them for their service. Servicemen and women are inundated at grocery stores, the local coffee shop, or just trying to have a meal with their family if they are in uniform.
In therapy, it would be even worse. Many don’t consider themselves heroes. They are the ones that made it home. The buddies that never made it back are the true heroes to them. For the most part, they don’t want to be called a hero and they don’t want to be thanked for their service. That is only part of what makes up their person and that is not why they came to therapy.
The service was the cause of PTSD, being called a hero might make them remember the guy right next to them that didn’t make it home. These kinds of remarks, though we might mean them in a good way, may be a trigger for the person that is hearing them.
They want to get help. They most likely, want to be direct and strategic about it. They want an actionable plan that can be put in place. Like most men and women seeking therapy, they may not want to dive into their feelings but rather deal with the symptoms as they present themselves.
Where Can Veterans Turn for PTSD Treatment?
Admitting that you’ve gone through something traumatic isn’t easy for anyone. Opening up about painful flashbacks and the horrors of combat that caused PTSD takes a lot of courage for a veteran.
Black Bear Lodge offers dual diagnosis treatment and trauma-informed care that can help you or a loved one move on from past trauma. Our master’s level clinicians can help you or a loved one get back on track. We are also in-network with TRICAREⓇ, the most common insurance provided to our vets.