Veterans: Where to Start?

Over and over we hear about how the returning Veteran is suffering from trauma, physical disabilities, anxiety, and so on. There is an abundance of information supporting the fact that Veterans face a higher incidence of divorce, drug use, and suicide. This has prompted significant focus on access to mental health for Veterans. When we think of these issues, what comes to mind? It is easy to jump to PTSD, anxiety, and other mental illness. So, at first, it was agreed:

We Start There!

Let's back up a second, though. While these are significant issues which we absolutely need to address, it is becoming more apparent in my work and in the world of research that this may not be the place to start.

 

“When I was in, it was easy. I had two jobs: Do as I was told and Stay undead”

“Civilians are crazy”

“Nobody makes any sense”

“When I was told what to do, we did it… at that moment. My civilian co-workers don’t do that”

“They think I am bossy when I am just trying to get everyone together and working. When I was in, I gave orders all the time and we got it done.”

“My family is so hard to talk to because they don’t get it”

“I offend people and don’t know why”

 

These statements represent that them that I hear in counseling sessions with Veterans. This is not someone talking about flashbacks, hyper-vigilance, nightmares, fear of going outside, or Depression. One, if not more, of those symptoms are usually present, but those are actually not always the issues for which these Veterans are seeking help. Whether these symptoms are managed or not, it is the struggle they described in the above statements which they need help with most. What they are describing is a struggle with

Successful Reintegration.

Among other things, this is the ability to resume prior social roles, connect and become part of their community, engage in leisure activities, and find meaning or purpose in civilian life. 

Remember before when we said:

We Start There!”?

We may have gotten this wrong for many of our returning Veterans. They are coming into counseling sessions expressing frustration about the basic issues civilians naturally understand since they have never been separated from this civilian society. Yes, these other mental health related issues may impact reintegration but one does not automatically have PTSD or other mental health issues just because they served. Reintegration does not only effect those who have been deployed to conflict areas. Living in the culture of the military alone makes reintegration difficult. Addressing the major mental health issues may not be possible if some basic readjustment can’t occur. Let’s listen to the experiences that these Veterans are reporting and help them start by addressing basic needs.

In a recent training with trauma expert, Bessel van der Kolk, M.D., he astutely pointed out that the Veteran doesn’t always need to learn to manage their trauma; sometimes they just need to learn how to manage dealing with people in a grocery store. If the perception “Civilians are Crazy”  is accurate to a Veteran’s reality, then, in a grocery store, we have just asked him/her to spend significant time in close quarters with “crazy” on a regular basis and survive it.

So how do we better meet the needs of these men and women? How do we break down resistance to engaging in work aimed at giving them the relaxed and enjoyable life they deserve and protected for the rest of us? It may be we move from the clinical to the practical. We acknowledge and understand:

  • the intensive training they completed to build protective factors meant for a war zone- so they can come home and protect home
  • the highly structured, black and white world within which they lived versus the gray world which runs on unspoken rules beyond laws, and the struggles of then returning to gray world living once again
  • that navigating social situations and making interpersonal connections outside the tribe are not skills which offer protection in a time of war. They can, at times, become a risk instead.
  • that if they learned and did well, then they had to suppress and, potentially, forget the rest.

Let’s remove the stigma of mental illness from the counseling session and replace it with skill building and redirecting one’s strengths, which have now become barriers.

Fortunately, our community does not have a deficit of resources. The Mountain Resource Center maintains a Veteran’s Support Services Program offering a variety of services which include job searching, emergency services, and funding for counseling (not just counseling for mental illness). For further information, you can contact them at (303)838-7552.

Additionally, Park County has a very involved and informed Veterans Support Officer who can be reached at (303) 816-9498.

The More “Subtle” Domestic Violence

 The More “Subtle” Domestic Violence

October is Domestic Violence Awareness month. We want to help bring awareness to this topic due to a chronic underestimation of the number of relationships impacted by Domestic Violence and to increase understanding of how to identify Domestic Violence.

This underestimation and need for education of the public is due to a number of dynamics related to this issue, including:

Secrets, Control and The “Subtle” Signs

Due to the heavily secretive nature of the relationship, others may not be aware of the violence. This secret is often maintained by fear of retaliation, shame associated with the victimization, a belief the victim is unable to survive without abuser, or fear the victim will not be believed.

When people are charged with Domestic Violence or a victim discloses, how many times do you hear:

“I couldn’t believe he/she would do such a thing”

or

“He/she is so kind and laid back, that's impossible”?

Looking beyond the surface, how likely is it one would get involved in a victimizing relationship if they knew the person was violent or they would live with domestic violence? How could the perpetrator avoid interference by those outside the family if they were to outwardly present as someone who was angry, controlling or abusive? Partners who have a pattern of controlling behaviors have a belief system rooted in entitlement, selfishness, superiority, possessiveness, and confusion of love with abuse (i.e. “I am jealous because I love you so much”, “I can’t stand the thought of losing you”). Outside intervention would be unacceptable and would challenge the legitimacy of their belief system. There is a lot about the perpetrator and their self-serving behavior which requires an investment in preventing any knowledge or suspicion they are perpetrating abuse. 

For many victims, abusive behaviors have been normalized for them in the relationship through a slow build up of controlling behaviors. The build up is introduced in such a manner it often goes unnoticed until it is extreme. Initially, there may be abuse followed by a “honeymoon” phase where the abusive partner is apologetic, kind, promises to change, and extremely loving. Overtime, this phase slowly disappears.

The main focus of this article is to SPEAK LOUDLY about the more “subtle” behaviors that may go unnoticed and not recognized as domestic abuse.

Together we can SPILL THE SECRETS! BREAK THE CONTROL!

Not all abuse is physical, and the presence of Domestic Violence is not only determined by physical abuse. It includes all forms of control and forms of abuse. The Colorado Department of Human Services offers a wonderful training book to their Caseworkers which outlines a variety of forms of abuse which constitute Domestic Violence which are often overlooked.

Below is a shortened list of their comprehensive descriptions (for a checklist identifying the presence of Domestic Violence, see our resource page):

Psychological: unwarranted and persistent jealousy, instills fear with tone or invasion of space, isolation (interference with communication with supports, picking fights before and/or after seeing or communicating with outside supports to make doing so not worth the trouble), humiliation, destruction of property, relentless attempts to prove the victim is crazy or incompetent

Spiritual: misuse of religious text to justify abuse, forceful conversion, degradation of beliefs

Medical: withholding medical care, preventing medical care, withholding necessary medications and medically related assistive devices

Legal Harassment: Threatens CPS or legal reports to maintain compliance with control, threatens removal of custody of the children, threat or actual retaliation to prevent cooperation with the abusers legal involvement, ignoring court orders including child support and contact orders, persistent frivolous legal battles

Deprivation: prevent sleep to argue, denial of basic needs, interference with supports

Sexual: forced sexual contact or unwanted sexual acts, sex in exchange for privileges, withholding of love if sex is not provided, sexual degradation

Economical: restricts or sabotages employment, full control of finances and financial decision making, declared ownership of shared assets

Stalking/monitoring: constant surveillance of electronic devices, monitoring of daily movements (unknowingly or with required check ins and immediate response to their attempts to contact)

Exploitation of Children: put downs of the parent to the children, interference with or undermining ofparenting, threatens harm to children for the purpose of controlling the other parent, use of children to monitor or provide information regarding the other parent

HELP

If you or someone you know is impacted by Domestic Violence, safety is priority. Contacting a professional to help formulate a safety plan is imperative. This can be a counselor, victims advocate, child welfare caseworker, or Domestic Violence shelter.

Other resources are:

Family Tree DV Hotline – (303)420-6752

Mountain Peace Shelter – (303)838-8181

National DV Hotline – (800)799-7233

SafeHouse Denver Inc – (303)318-9989

If you know of a child who is being exposed to Domestic Violence, make a report to the Colorado Department of Human Services Child Abuse and Neglect Hotline:

(844)CO-4-KIDS

Reference:  https://endingviolence.com/wp-content/uploads/2013/01/Colorado-DV-CPS-Practice-Guide-4.14.131.pdf

 

- Alison Atkins, MS, LPCC

Learn more about Alison here

Learn more about Alison here

Posted on October 19, 2017 and filed under awareness.

Managing Media Trauma

Media is a source of information which tunes us into the events of the nation and the world. It brings us information and experiences from our neighborhood to the neighborhood of a foreign land. Much of media content is composed to get your attention and increase the number of consumers. The more interesting, dramatic, taboo, exciting, and outside our normal reality, the more the public can not help but to take in what the media has to present. While there are benefits to knowing what is happening in our world, there are consequences to the volume of images and audio which barrage our senses.

When traumatic events occur, the media puts aside the day to day news and replaces it with the horrific details of how the crisis is unfolding. Whether the intention is to bring awareness, increase ratings, or document history, the public ends up glued to the news channels, papers, online forums, and social media. Our world is flooded with sights and sounds of atrocities beyond the norm. The safety and balance of our society is rattled.

It is easy to believe the screen of the TV or computer removes us from the trauma. It is becoming more and more understood the incredibly negative impact this experience has on us. A study was published in 2013 regarding the mental and physical effects of exposure to media coverage of 9/11. The authors found extensive exposure to media coverage can turn a vicarious experience into a collective trauma. Additionally, it doesn't even have to be the video and audio we often see. Simply being subjected to still pictures of strangers experiencing trauma can result in a stress response.

So how do we deal with the disasters in the world which we find both tragic and fascinating? How do we keep from being traumatized ourselves?

 

1.Take Notice of Your Feelings: Don't passively watch. Check in with yourself and see if you are having strong reactions of fear, anxiety, disorientation, trouble sleeping/nightmares, changes in eating, pervasive thoughts of the event, feelings of lack of safety, overwhelming sadness. Notice them and put them in context. Understand they are related to the event coverage rather than your immediate situation.

2.Express Your Feelings: To put it mildly, these things are awful. We are allowed to have a strong emotional response to them. Express your anger. Cry if needed. Just because we are not living it, does not mean we are disconnected from the devastation of our fellow humans. We are all members of the human race and empathize with the experience of others. We are equipped with empathy to feel for and be compassionate towards others. It is important to community and humanity. Dr. Ramachandran, a cognitive neuroscientist, found evidence our empathy is connected to our mirror neurons. These are the parts of our brain which cause a baby, within the first month of life, to stick its tongue out just as their parent does. It's the learning which takes place by watching and mimicking others. If we watch someone reach for candy, the same areas of our brain light up as if we were reaching for candy ourselves. If we watch someone in anguish and fear, the same areas of our brain will light up as if the fear and anguish was ours. There is a feeling of connection to those we see in the media clips and will feel sad and scared for them. Express this and permit yourself to be okay with having these feelings.

3.Turn It Off: If you are having overwhelming reactions, turn it off. Turn off the TV. Stop searching the internet. Take a break from social media. A digital detox is recommended under normal circumstances. A digital detox is a great way to shut down this influx of terror and allow yourself to manage those feelings.

4.Mindfulness: Meditation and mindfulness calm the stress responses. It refocuses us on the here and now. It directs our mind away from the "what ifs", worse case scenarios, and universalizing of the fear.

5.Self-Care: When we are mindful of our self, we can identify our needs and tend to them. Maintaining a regular sleep cycle, continuing with a normal eating pattern, regular activity, and engagement in enjoyable activities helps to manage stress responses to a collective trauma.

 6.Look for the Good: Terroristic acts are meant to destroy a large population through fear and destruction. As a people, we respond with some very contrary behaviors. We become closer and demonstrate a selflessness not seen under normal circumstances. People sacrifice their safety to save others. Communities pull together to rebuild that which has crumbled around them. Large stadiums of people come together in moments of silence. Masses of people give of their time and resources to provide for those in need. There are an abundance of stories of bravery. These are the stories which deserve focus and remind us there is a lot of good in our life. Use these stories to identify other goods in your life and have appreciation for the things we do have.

7.Don't Forget the Children: It is easy to think our kids don't understand and, therefore, aren't effected by what is happening. Keep in mind their reactions may not be obvious so it is harder to see the impact it is having on them. The same study on the effect of media exposure mentioned previously also measured the impact of media exposure of 9/11 on children. They found children as far as London demonstrated post traumatic stress responses to the event. This brings to light the reactions children can have to the news.           

Some responses to take notice of are increased stress, anxiety, fear, grief, difficulty concentrating, themes of disasters or death in their play or art work, and behavior problems. You can help ease these reactions by helping them understand what is happening, put the event in context, explain how the media works as far as sensationalizing and their focus in crises, help them remember good things, reassure them of their safety, and be sure to validate their feelings. Avoid things such as telling them they are overreacting or it didn't happen to them so they shouldn't be so upset. If their responses become intrusive and disrupt their daily functioning, it is okay to talk to professionals (e.g, school staff or counselors) about helping your child process what they are going through.

 

In the end, let us not over estimate our immunity to these issues. Let us not underestimate our resiliency. It is difficult to know of these acts and the devastation they cause but we are able to manage these feelings and move forward. Proactive care of ourselves is a great protective factor to prevent stress and collective trauma.

-Alison Atkins, MA, LPCC                                                                                                 

Posted on October 5, 2017 .