Always a Soldier Presented by
Alicia Bogard, MSW, LISW-S, CFLE
IntroductionCultures of WarCompassionCommunicationConclusion
Outline
Are you a Veteran?
Loved one a Veteran?
“I do not want to be dependent on anybody. I developed this belief the day that I joined the Marine Corp. “Once a Marine, always a Marine.” It is important to me to remain stoic. I do not believe in crying and if I have to then it will be in private. I am not sure if it serves a purpose, but feels like it is cowardly to do.” * Vietnam Veteran
Branch of the Military (Army, Marines, Air Force, Navy and Coast Guard)
Draft vs. Enlisted
Not Stereotyping
Cultures from Each War…
Differences to Consider
World War II:
◦ Heroes and Praised.
◦ Did not speak about what happened
◦ “Shell Shock”& “Combat Fatigue”
“During the war,
I earned a lot of metals, but did not speak about them because I
did not want people to know
what I did. “* World War II Veteran
Cultures from Each War
Korean War:
◦ Viewed a “Conflict”
◦ Not supposed to be any wars after WWII
◦ Feel overlooked
“ and when the war was over, the Chinese military puts their guns down and wanted to shake our hands because they called a truce.”
* Korean War Veteran
Cultures from Each War cont.
Vietnam War:
◦ Media Coverage
◦ Divided Country
◦ No gratitude or appreciation for veterans
“Being in Vietnam, I
believe was a waste and there was no reason. “ * Vietnam Veteran
Cultures from Each War cont.
Gulf War/Dessert Storm Veterans◦ Exposed to nerve
gas◦ Increased rates of
brain cancer, lung cancer, debilitating chronic diseases and pain, increased risk for Alzheimers
Iraq/Afghanistan Veterans
◦ Struggling when they return to civilian life
◦ Job skills do not translate from military
Cultures from Each War cont.
Person came home a different/changed person◦ Veterans returned home & their family told
them they did not know or recognize them Veterans worried about their family finding out
what they did/had been through
Rape in Military/Conceiving Children
Substance Use to Cope
Family Dynamics
Family Dynamics cont.
“ I left my family because I went to get milk and never came back.”
* Vietnam Veteran
Domestic Violence due to still being in “combat mode”
Being military family is a different lifestyle◦ Stoicism◦ Different Lifestyle (traveling/changing roles)◦ Loss of Friends (technology not the same)◦ Concern about Pensions
Post Traumatic Stress Disorder (affects them in large crowds, ability to keep jobs and relationships, interactions with the law)
Veterans can have a distrust of any authority
Co-morbid conditions are often present (anxiety, depression, substance abuse, social or family issues)
How Does This Effect Us as Professionals?
Addressing all areas of health: Spiritual, Emotional, Social,
Physical & Cognitive
Looking at possibility that physical pain can be related to underlying pain in other areas
Holistic Approach
Forgiveness Issues
Isolation
Guilt
Guided Imagery
Use Ritual to help bring healing (memorial rocks, pinning, bracelets, letters to the living or the dead)
Compassion
EMDR returns information processing to normal, the memory is still there but it is less upsetting, less intense, less stressful
EMDR is a eight-phase integrative treatment approach
EMDR uses bilateral stimulation(eye movements, taps, audio tones) to reprocess information, which appears to be similar to what occurs naturally during dreaming or REMsleep
EMDR
“There are not documents for
everything I went through, but you do not dream up stuff
like this.” * Vietnam Veteran/P.O.W.
Communication with Veterans IS different than other patients you serve
Veterans are trained at a young age how to communicate the necessary and hold everything else in
Stoicism
Triggers
Communication
Do NOT ask if they are veteran. ASK if they ever served in the military.
Do NOT assume- not all veterans view their military experience as negative. ASK THEM.
When asking if they are in pain- ask if they are “uncomfortable” as many veterans will not admit they are in pain.
Ideas when Communicating
Lead in questions about other topics to develop trust
Some military leaders believe the word “disorder” makes soldiers reluctant to ask for help- they would like to change the name to Post Traumatic Stress Injury
This is a debate if the military environment needs to change and not the disorder.
Be present and have time to listen when Veteran does open up – this may take time
Ideas when Communicating cont.
Conclusion
Bolte-Taylor, J. (2008). Stroke of insight.
DMS-IV- Diagnostic & statistical manual of mental health disorders 4th edition.
Grassman, D.L. (2010). Peace at last: Stories of hope and healing for veterans and their families. Vandamere Press: Florida.
References
Koepell, Barbara. (2015). U.S. Nerve Gas Hit Our Own Troops in Iraq. http://www.newsweek.com/how-us-nerve-gassed-its-own-troops-then-covered-it-317250
McKay, Heather. Dementia Care for America’s Heroes.
Padin-Rivera, Edgardo. Post Traumatic Stress and End of Life Concerns.
The Hospice-Veteran Partnership of Ohio Fact Sheet 2010
References cont.