lessons from the field manual

IMG_1156this is dedicated to my father who was in France on that day in the 1940’s.  he taught me my first lessons in loving a veteran. 

*Most come prepared. I wouldn’t expect a former green beret, a navy seal, a marine, or even the best infantry soldier, to attend a first-time therapy appointment any other way. Often, they’re carrying a clipboard or notepad that I watch them use to store notes and therapeutic assignments. The other hand they use to shake mine firmly.   What stands out is the contradiction of their seeming preparedness running parallel to the visible anxiety that engulfed them. Their palms are sweaty when we shake hands and their eyes wide open.   During our second appointments, they are surprised to learn that in the first session I’ve noticed how they quickly scan my office for potential harm while mapping an escape route. I ask all my veteran or active duty clients about SERE training. For those who have been through the training, they can quickly assess which phase their physiology is set on during the initial therapy hour. The acronym, SERE, standing for Survival-Evasion-Resistance-Escape, is a program provided to US military personnel that prepares them for worst-case scenarios. Once, I had a soldier tell me he was preparing for “escape” because the standard questions I was asking as part of my initial interview felt “like incoming fire”. To this day, information-seeking in the form of questions takes a backseat when I’m meeting a service member for their first session.

Once, I had a soldier tell me he was preparing for “escape” because the standard questions I was asking as part of my initial interview felt “like incoming fire”.

I usually hear some version of their primary concern as “I’m about to blow” and are concerned that building anger will create unbearable loss. They’ve often alienated nearly everyone in their families by vacillating between days of stonewalling and sudden bursts of rage. They describe, at times, being trapped in a corner with memories of hell and mayhem while painfully aware they want to protect loved ones from uncertainty that they can survive this post-war battle. Even with me, they spent the first few sessions apologetically explaining that they’ve done “horrible things, ma’am”.

 They frequently express feeling foolish for what is perceived as a failure in overcoming the perils of being “outside the wire”.

For some, its been 10 years or more since they discharged from the military and even longer since they’ve trusted anyone other than their band of brothers. That first session is usually  a big day for both of us. For me, I feetl the urgency of needing to be at the top of my therapist game. For them, the step toward asking for help and trusting the process is nothing short of a quiet miracle.

Though the daughter of one and wife of another, I am not a veteran, so some would argue I am not the best person to help these strapping, tenuous warriors.  Yet, the courageous trust many of them have placed in me, coupled with my insistence on excelling at my vocational calling, has taught me some lessons about the road to recovery many veterans must walk. On this Veteran’s Day, 2016, I reflect on some of those lessons in honor of the men and women who have become my most treasured teachers.

  1. Veterans need an absence of reactivity. Stories of combat are some of the most egregious ever told. Hearing them may evoke images and strong emotions in the listener.   The veteran needs to know you are strong enough to help absorb and hold that story. The emotional and mental hurt they’ve endured is overwhelming. The last thing they want is to harm someone else with their journey.
  2. Veterans are more than just the culmination of worst combat scenarios they’ve lived. Most veterans I see in my office are sons, daughters, husbands, wives, fathers, and mothers. They have goals and dreams that reach farther than their next abreaction or trauma response.
  3. War has changed them, forever. Significant shifts in values and belief systems happen when someone is trying to kill you or your brothers- and sisters-in-arms. I never ask the veterans I treat to check those values at the door. For some of us, the intensity with which a veteran might live their life can be overwhelming. For the veteran, it is the foundation for their ‘new normal’. It’s up to us to help them build a balanced, healed life on that foundation rather than have it come crashing down around them.
  4. Wanting to rejoin their unit in a foot patrol that carries great risk does not mean they want to abandon their family stateside. For some, there is heavy grief that comes with separation from the military. It collides with the guilt they feel at being separated from their families by catastrophic memories or an unusual urge to re-enter the pangs of combat.
  5. Even without deployments or combat, the sacrifices of veterans are enough to warrant our gratitude and ongoing service in the civilian world. For a service member, the training alone is more than most civilians could withstand on any given day. Their willingness to be ready for war is an intangible to be revered. Understanding how that work ethic translates into any employment or civilian opportunity would serve us all well.
  6. Banners of thanks are tolerated. Actions of support are needed. We must abandon any romantic notions we have about welcoming our troops home on the tarmac and waving banners of thanks. We need to continue our research on best practices in mental health care, strengthen our funds of support for their transition, and be the best at it.

Oh, and those veterans that choose my space to explore healing? The road to recovery is ongoing. Some days are better than others.  I periodically ask them what our number one mission is in working together. They always answer, in some form or fashion, the same way. “I just want to trust myself again, ma’am”.

If you are a veteran in need, or you love a veteran, please consider these resources:

Veteran’s Crisis Line – 1.800.273.8255 or http://www.veteranscrisisline.net

Vets4Warriors – 1.855.838.8255 or http://www.vets4warriors.com

Give an Hour™ is a nonprofit 501(c)(3), founded in September 2005 by Dr. Barbara Van Dahlen.  By utilizing volunteer mental health professionals, GAH is dedicated to meeting the mental health needs of the troops and families affected by the post-9/11 conflicts in Iraq and Afghanistan.  GAH works to provide counseling to individuals, couples and families, and children and adolescents.   http://www.givenanhour.org

* The descriptions of veteran clients given are never from one, factual client. I intentionally change key details to protect the privacy of my clients and have, instead, borrowed elements of many who highlight my experiences over the course of 20 years as a counselor/therapist.  The essence of the lessons I’ve learned is completely and fully authentic.

About chris cannida

I am a psychotherapist, trainer, and consultant hoping to help others find a peaceful and meaningful sense of self, while improving the quality of their lives. My background includes extensive work with post 9/11 active duty service members and veterans. All writings on this site are currently dedicated to the mission of helping our military community remain mission-ready and resilient.
This entry was posted in 9/11, Military Mental Health, Therapy, Uncategorized, Veterans, War. Bookmark the permalink.

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