Veteran therapy
by Ron Burian, MSW
In short, it’s active listening, linking to resources, with no rush to reassurances. In that, it is not so different from any other caring intervention, yet, being with a veteran does offer some unique challenges. I will be writing from my perspective as a combat veteran of the American war in Vietnam.
You Are the Important One
It’s important to note that a veteran would most likely be able to relate with another veteran. Shared knowledge and experience would be helpful, but I have found that few counselors or social workers are combat vets. If you find that you are the one listening, the one hearing the veteran in that moment, you are the important one. Do not rush to refer, and do not rush to reassure. Just listen with all your heart. Find your own way to prompt, your way of asking, “What’s happening?" and “Anything else?” Later, ask if the veteran would want to be helped to a referral. Know the Veterans Crisis Line is always available at 1-800-273-8255, press 1.
PTSD
PTSD: Much has been put out there about PTSD since the 1960s. It comes in many forms from mild to severe. Remember that it can be unexpressed for a long time, or perhaps never expressed. It may be 70, 50, 30, 10, or 2 years later that a veteran chooses to talk. An uncle waited until he was on his deathbed to speak of WWII combat experiences for the first time. In late 2017 and early 2018, there were many news stories and an 18-hour TV documentary about the Vietnam war. These may have triggered memories and may prompt some veterans to remember, to seek counsel, to talk. It can’t be known what will bring a remembrance.
Moral Injury
Moral Injury: Less well known is moral injury, but it is increasingly coming under study and to the awareness of the healing community. Basically, it is a violation of deeply held moral convictions. Given that the business of the armed forces is sometimes to kill people and/or be killed, it will be safe to think that a veteran may be experiencing some form of moral injury, often mixed with PTSD. Keep in mind that sometimes "just not doing enough" to protect other soldiers, or not doing enough to restrain or prevent others from doing a morally reprehensible act, can result in moral injury for the viewer. There also may be cases when the veteran comes to understand that an entire conflict/war is wrong. This may result in feelings of being betrayed by commanders and country, or feeling isolated from much of community.
Faith
Please, please, be as interfaith as possible. Be willing to hear what is true for the veteran, as this is probably not the time for you to explain, convince, or reassure the veteran of the rightness of YOUR world view. The Veteran’s God may be called to question for acts seen or done in conflict/war, or God may have died on the battlefield along with the veteran’s best friend. This is probably the time to let the veteran talk, and by talking learn from what his/her own voice is saying aloud. There are also other systems of belief that may not have the attributes in which you believe, yet may be serving the veteran’s spiritual needs.
Listen. Actively listen.
Peace be, Ron Burian, MSW, Combat Vet
Ron Burian, MSW, is an Army infantry combat veteran of the American war in Vietnam, 1968-1969. He was a brick/stonemason for 20 years, before going back to college for an MSW from U-W Madison. The next 16 years were spent as Clinical Research Interviewer for Northwestern University, taking self reports from at-risk youth, felons, and ex-felons in Illinois prisons and the streets of Chicago.