What Are We Thanking Them For? Perspective from a Veteran’s Therapist

In the week leading up to this year’s Veteran’s Day I’ve heard “thank you for your service” spoken to an array of veterans (and active duty service members) for about a week now.  First, it was a young girl who saw an airman standing in line at the convenience store one morning on his way to drill weekend.  Then, it was to the elderly gentleman at the grocery store wearing his Vietnam Vet baseball cap and buying his milk, spoken by the young man bagging his groceries who shared that his grandfather had also served.  So it goes here and there, online and in the community.  Thank you for your service.  At the same time, as more and more veterans and active duty service members are finding their way into my office for therapy, I discover myself being a bit curious about all this gratitude.  Do we really know what we’re thanking them for when we say it?  So many of us imagine that we’re thanking them for putting their lives on the line, leaving their families for months on end, and marching through combat zones hoping to return in one piece.  After all, except for loss of life, that’s the ultimate sacrifice they make.  Many veterans have done just that.  Still other warriors never returned to hear the words “thank you”.  For their sacrifice, we say it to grieving spouses and mothers, to small children who’ll have to hold tight to a few years of memories.

I mostly say things like “I’m glad you’re here” and “It’s going to be difficult work some days, but we’ll do this together” and of course, the ever-dreaded “How does that make you feel?”

Yet, being a therapist who’s offered counseling both on military installations and in the civilian sector, the stories of sacrifice unfold in ways most grateful citizens can’t imagine.  So this year, I thought I’d reflect on what veterans teach me every day about sacrifice.  This way, when I say thank you for your service, I can be as genuine and knowing as possible.  While I risk sounding a bit cynical or morbid, it is actually my hope to shed, more fully, a light on the sacrifices made for the sake of your and my freedom.  I hope readers can forgive any dark shade my reflections pour on the patriotism and honesty we all feel when we extend our words of gratefulness to veterans.  Bear with me as I offer a glimpse in to some of the sacrifices veterans have made for our nation, as seen by a therapist who hears the rest of the story on a weekly basis.

Veterans from the Vietnam War era came home more frequently to hatred rather than gratitude.  I stood on the sidewalk at Ft. Bragg 7 years ago and watched a Colonel break down in tears as he told me the story of standing at a bus stop in the nation’s capitol while people spit and threw their drinks on him – because of his service.  He was serving in the post 9/11 era and still faced the perils of activists with misguided actions.  For those who served in Vietnam, it was even worse.  So when I thank a veteran, I’m thanking them for enduring the egregious offerings of a sometimes, ungrateful nation.  And I think of that Colonel who sacrificed his own nobility to cry on that sidewalk so he could share his story.

Meeting their spouse’s new partner on the tarmac when they get off the plane amidst “welcome home” signs, ticker tape and fanfare.  Let’s be clear.  I’ve seen this happen.  Marriage in the military is difficult.  If a service member’s marriage is young or strained before they begin a constant stream of deployment to combat, long-term training, or schools for advancement, getting the help they need from marriage counseling becomes nearly impossible.  Many couples begin the process of marital healing only to have “orders” interrupt their efforts.  He (or she) now has to leave for weeks of training and the counseling is upended.  I’ve watched service members return to houses emptied of all the furniture and a note left ending the marriage and family unit forever.  I’ve sat with a soldier awaiting to board a plane for the middle east just after his spouse dropped him off for that flight and announced she couldn’t suffer another deployment worrying about his fate – so she was filing for divorce. For the spouses who make the decisions to leave, there’s no blame from the therapist’s chair.  I’ve watched spouses try hard to manage their own depression or anxiety, be single parents for 15-months at a time, and collapse under the strain of wondering, with every breath, if their spouse will return intact, or even at all.  That kind of anxiety can’t be easy to bear.  Marriage is sometimes the casualty of war.

Many veterans discover that once honorably discharged with at least a middle-management level of training and experience, they have to start at the bottom of the vocational barrel or educational pursuit.  Getting a college degree is difficult for a service member because of moving, training schedules, combat deployment, and long days on the regular calendar of reporting for duty.  If an enlisted soldier doesn’t have a degree when they join, education is an automatic back-burner event.  Even in the days of online education, the logistics of serving and going to school puts a heavy strain on military members.  Those online degrees come at an exorbitant cost.  If they do go straight to the civilian sector for work, the civilian employers often don’t know how to translate military rankings and experience into the equivalence of job expertise.  This leaves many veterans underemployed and underutilized.  If they were leaders of men and women in the army, they end up with no one to lead at the bottom of an employment ladder.  This takes a psychological toll, leaving many of them feeling lost and out-of-place.  Going from being the leader of a “band of brothers” to isolated and the rookie of an unfamiliar band is hard.  Many of them see no other choice, so they humbly start where they must to bring home a paycheck.  Ask any mighty marine or soldier what it’s like to feel helpless.  When I ask them this question in the therapy space, the spew of curse words that sometimes fly……well.  Let’s just say it’s difficult to feel that helpless and isolated when you’ve been trained survive war along side men and women you’d die for.

They’d give anything to feel whole again.

Military kids sometimes have to change schools an average of 6-9 times between kindergarten and graduating high school during their military parents’ careers.  Making friends as a kid can be tough.  Even I felt tentative and unsure about whether those peer connections were real and I went to school in the same small town for the entirety of my youth.  Can you imagine having to wonder about a new set of peers every three years?  No, thanks.  Yet, shout-out to all the military kids I know who are the ultimate troopers – resilient, strong, and articulate.  Not to mention that many of our military kids whose parents serve in the National Guard or reserve units attend primarily civilian schools not near large military bases.  For them, when the stresses of military life are bearing down, their teachers might not have the training and insight to understand that little Johnny is suddenly dropping his grades or acting out because of separation from his parent or fear that parent will die.  Unfortunately, some combat veterans come back from war believing they are less than when they entered war, and their medical issues or loss of limb are stark reminders that they give more than most of us could ever dream of giving.  For any person, that moment – the moment of feeling less than – becomes a sacrifice too heavy to bear.  They’d give anything to feel whole again.  Until that day, if it comes, their kids live with an oddly present, yet absent parent.  The sacrifice of meaningful attachment becomes the never-ending sacrifice for some military families. 

This small list doesn’t begin to describe the lifetime of sacrifice in store if the veteran suffers moral injury, post-traumatic stress, TBIs, or the multitude of service-related medical issues that can arise.  I could go on about the scores of chaplains and commanders who’ve witnessed sons, daughters, mothers, and fathers breathe a last breath.  Or the battle buddies who will spend the holiday choking back tears shed for the fallen comrade.  And then there’s the marine who thought he was going to spend Veteran’s Day reuniting with his entire team, only to learn that one died at the hands of suicide just last week. 

In case you haven’t heard – warriors are trained to deny their feelings and that’s the first thing I’m going after in the therapy space. The ultimate clash of the titans.

Even as I consider the scores of sacrifice by veterans while they served, I can hear the voice of several veterans I know who would read this post and say, “Dang, Chris, you make it sound like we want sympathy!  We don’t. We just want to live our lives, provide for our families, and be okay again”.  Being the therapist to veterans and active duty service members is a highlight in my career and includes many honest, and often blunt, exchanges between me and my veteran clients. Veterans who become therapy clients are the best kind – direct, aware, and painfully honest. You might be surprised that I rarely say “thank you for your service” to them when they become my clients.  I mostly say things like “I’m glad you’re here” and “It’s going to be difficult work some days, but we’ll do this together” and of course, the ever-dreaded “How does that make you feel?”  In case you haven’t heard – warriors are trained to deny their feelings and that’s the first thing I’m going after in the therapy space. The ultimate clash of the titans. I’m grateful and humbled by their courage to let two worlds collide – their warrior world and their emotional world. When I do (out of habit) say “thank you for your service, I appreciate you”, they grin and muster a humble “you’re welcome, ma’am”.  I solicit an agreement that they won’t continue calling me “ma’am” (they do anyway), and we continue the work of their healing together.  Sometimes our therapy work ends with a handshake, and on occasion, they ask if they can have a hug.  In irony, the gratitude they feel compelled to express for a safe space to heal makes my ‘thank you for your service’ seem so insufficient.  But, I’ll continue to find ways to express my sincere gratitude and be forever mindful of the real sacrifices they’ve made.

Any similarities a reader might find between their own story and the elements of this writing are purely coincidental. All efforts are made to change identifying details (rank, time period, campaign served, gender, etc.) to protect the identity of any person mentioned. The essence of the story, however, remains authentic in honor of the men and women who have humbled me with their disclosures.

National Suicide Prevention Hotline – 1-800-273-8255

Note: This information is not intended to replace the medical advice or treatment of a trained professional.  If you feel your needs are creating an unsafe situation for you or someone else, seek emergent care through your primary care physician or local emergency room.

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PTSD: A “Not-So-Invisible” Wound

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June is PTSD Awareness Month. PTSD (Post-Traumatic Stress Disorder) is the official name of an injury listed in the DSM V (the most current Diagnostic and Statistical Manual of Mental Disorders). Clinically, it’s considered a specific form of anxiety. Yet, in recent years it has been referred to as an invisible wound because of it being not readily visible by others who may be interacting with the person challenged by the symptoms. We now know it’s not just a psychological wound, but also an injury that’s been imposed on a person’s nervous system. Because of its covert existence, PTSD sometimes goes undetected for periods of time or can even be mistaken for other mental health illnesses because of its shared symptoms with those diagnoses. Though for those individuals whose lives are turned upside down by PTSD, it might be considered the “not-so-invisible” wound. The personality changes they undergo and the way their bodies respond to the impact are life-altering, sometimes creating distress that seems impossible to bear.

In order to erase the stigma behind what is officially a mental health illness, some in the healthcare profession have dropped the “disorder” and just say PTS. While a person’s life can be dis-ordered by the impact of trauma and they might actually feel physically ill by its presence, addressing PTS as the injury it is can lead to more accurate understanding and care. Excellent care for those wounded in this way is the most important reason to gain as much comprehension as possible. In our communities, that understanding can lead to the development of necessary resources for those that suffer from PTS.

“…..for those persons whose lives are turned upside down by post-traumatic stress, PTSD might be considered the “not-so-invisible” wound”.

Regardless it’s call-name, post-traumatic stress can be as debilitating as any physical injury suffered by someone. The impact can be life-changing, whether managed swiftly or lingering for years. If there are multiple traumatic event(s) or the trauma experienced is prolonged in nature, a healthcare provider may refer to the stress response as complex post-traumatic stress. Either diagnosis is accompanied by a litany of distressing changes in how the person copes with his/her life. Some of those changes might be physical in nature, such as severe sleep deprivation and even headaches or nausea when recalling the traumatic event. PTS can cause major changes in what we believe about ourselves and the world around us. One of the most uncomfortable changes is how our nervous system responds to being startled or while having even just having thoughts about the traumatic event(s). This is called hyper-arousal and happens when a person is triggered by something in their environment that has even the slightest resemblance to the original trauma. When a person’s life is stricken by these stresses, he/she is likely to do whatever possible to avoid reminders of the trauma. This avoidance may cause that person to change how they exist in the world by removing themselves from otherwise healthy socialization (isolation). The internal disruption caused by the PTS wound can leave someone feeling stuck on an emotional roller-coaster without escape. Called emotional dysregulation, this upheaval in their emotions is not only stressful for them, but can be equally overwhelming for anyone in proximity to the person suffering.

The internal disruption caused by the PTS wound can leave someone feeling stuck on an emotional roller-coaster without escape“.

In the United States, and in part as a result of the post-9/11 wars in Iraq and Afghanistan, PTS has received a much-needed increase in the attention it receives. Mental healthcare providers, desperate to encourage service members toward asking for help, have done remarkable work in advocating for treatment of PTS. Though anyone, regardless of the nature of trauma (rape, childhood abuse, near-death accidents or illness), could meet the criteria for PTS. Even being in long-term relationships with emotionally unsafe people is known to produce symptoms of post-traumatic stress. Thankfully, there are treatments that are effective in treating the injury. While medications may be prescribed as part of a treatment plan, there are multiple treatments available that do not require medication.

If you believe you or someone you care about is suffering from a PTS injury after being exposed to trauma, please consider reaching out to a healthcare professional in your community. There are people who know this wound is “not-so-invisible” to you and are able to offer relief from its debilitating effects.

To learn more about PTSD, please join me as I partner with PsychHub.com to educate about all mental health issues and available treatments. Click below: https://psychhub.com/partners/l-chris-cannida-lpc

National Suicide Prevention Hotline – 1-800-273-8255

Note: This information is not intended to replace the medical advice or treatment of a trained professional.  If you feel your needs are creating an unsafe situation for you or someone else, seek emergent care through your primary care physician or local emergency room.

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