Being Tender yet Tough with Veterans

As any subgroup of Americans, military veterans cover a wide spectrum of personality types and pre-service adjustment history. While there is almost universal agreement that veterans should be honored for serving, across the board admiration without constructive criticism may be unwise. Not every hero acts heroically all the time. Sometimes folks with adjustment difficulties need tolerance and tenderness; but sometimes they need toughness and truth. Military veterans are no different. Three points worth considering in detail come to mind.

The alarming suicide rate may not simply be due to cultural and economic difficulty in reintegrating “into the world.” Many times suicide is an extreme case of rage and anger expression meant to hurt others deemed responsible for the pain felt by the suiciding individual. Unfortunately any person having difficulty expressing strong emotion prior to enlisting might likely be at greater risk to demonstrate unhealthy emotional expression after being stressed by military life, especially combat. Help for such predisposed individuals probably requires retraining in emotional intelligence where a certain “tough love” adherence to abstaining from careless emotional and social acting out is enacted. Like a substance abuser needed to work a program of sobriety, emotionally immature vets might need to increase careful self-discipline when attempting to convey strong and complicated emotion.

Second, it is not accurate to say that services in the VA system are unsatisfactory or unavailable. Well over 85% of veterans report being highly satisfied with help gotten in this system (Even though surveys are oft used for political agendas and there are at times horror stories of care gone wrong). Plus is it not a complete picture to conclude there are unacceptable wait times in the VA system. Since 1979, veterans have been able to use the walk-in, storefront clinics of 300 Vet Centers nationwide to get immediate support, social service and counseling. For over three years in the 1980’s at the Memphis Vet Center I personally conducted a weekly, open ended support and therapy group in which hundreds of men and woman worked through a full range of issues. There is no wait in these “store-front” services, veterans just “walk-in.”  Additionally, there are currently available online and smartphone delivered services for those who suffer from PTSD. Any veteran who wants and needs treatment can get it in a timely fashion.

https://tango.uthscsa.edu/ssads/040/

Additionally the detail, quality and efficiency of treatments available for PTSD is increasingly outstanding. Here’s a website, cptforptsd.com, that explains the treatment in clear terms and provides a searchable list of therapist certified to conduct it.

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Finally, it could well be that something else is operating in the lives of those veterans who do not avail themselves of services before taking self-destructive action. Recent efforts by dedicated VA mental health practitioners are focused on discovering the parameters that make veterans reluctant to seek treatment (such as Strong Star, https://tango.uthscsa.edu/strongstar/).  A number of helpful resources are beginning to emerge which address such reluctance, like Donald Meichenbaum’s Roadmap to Resilience for veterans and their families or my forthcoming book with Beth Fehlbaum, Trauma Recovery: Sessions with Dr. Matt. These books provide information about what recovery treatment is like and hopefully give inspiration to overcome the reluctance.

Most experienced trauma therapists know that timing is crucial in successful treatment. Sometimes, tenderness and tolerance is required where authentically “being with” someone without judging helps. Other times, a more tough approach is needed to challenge with helpful truths a person who is stuck in a devastated life. If we agree that military veterans deserve our best support, we probably have to dig a little deeper to determine what they need. In the meantime, welcome back, guys; and Happy Veteran’s Day.

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