This site has information developed over 35 years of study and work in clinical psychology, most often with combat veterans (bio, CV). While anyone might find the material interesting (Really, isn’t everyone a psychologist?) this site specifically addresses:
For therapists with a specialty interest there is an ongoing discussion of EMDR including reconsideration of what has come to be accepted as official thinking about its various aspects. A second discussion addresses other mental health related subjects. Posts critically considering “moral injury” have been added recently.
Don’t I Have the Right to Be Angry?: The HEArt Program for Veterans and Others Who Want to Prevent Destructive Anger
EMDR and Psychotherapy Integration
More about Howard Lipke
The attached paper is a variation of my entry in Charles Figley’s (2012) Encyclopedia of Trauma: An Interdisciplinary Approach.
The brochure For War Veterans & Family: On Combat Exposure was written in late 2008 for veterans and their family members who were connected to the Stress Disorder Treatment Unit (SDTU) at what was then the North Chicago VA Medical Center, and is now the Lovell Federal Health Care Center. Although there were many educational materials available on the psychological effects of combat (e.g. National Center for PTSD internet resources available at: http://www.ptsd.va.gov/public/) these appeared to focus on describing PTSD symptoms, attempting to normalize them, and encouraging treatment. They certainly met a need, however, their focus on diagnosis and symptoms failed to address essential issues that would help to clarify a reasonable understanding of how the effects of combat related stress might occur, and what paths might lead toward relieving them. The standard approach also did not answer many of the questions that had arisen over the years from veterans and family members.
In an effort to meet these needs work began on the brochure. As was the process with many of the clinical materials developed for the SDTU, after a first draft was completed by staff it was presented to groups consisting of residents and some alumni outpatients of the SDTU program. Their feedback was incorporated into subsequent drafts. This process continued until there were two consecutive groups who found no objections to the material. The brochure was then made available to veterans and family members in its completed form.
Below are two paragraphs from a paper on stigma, especially as it applies to veterans. (Actually there are two papers, one addressed to veterans and one more academically written for MH professionals) In the second paragraph it is suggested that if vets, or anyone with trauma related “symptoms,” is going to get down on themselves they should at least “Get it right.” which is the name of the academically oriented paper these quotes come from.
That stigma (being marked or believing one is marked as disgraced) is a primary barrier to veterans seeking help to overcome the destructive psychological effects of trauma is one of those cultural phenomena which is easy to see, widely acknowledged, and also supported by research (Hoge et al 2004) . As is often pointed out, the stigma has two manifestations, (e.g., Corrigan, 2004) the belief by others that the need for psychological help is a sign of essential inferiority, and the same belief held by the self. Both are important with the self-stigma clearly most damaging.
- Current stigma term: Crazy Vet
More accurate term: Stuck Transferer
This is the stigma associated with re-experiencing symptoms. “Stuck Transferer” refers to the idea that flashbacks and reliving nightmares are a manifestation of unprocessed memory. In Horowitz’s terms (1976) memory has not moved (transferred) from short term to long term storage. In the version presented to veterans this is called moving from “reliving” to “historical” or “intellectual” memory.
As a psychology graduate student, in the 1970’s, I came across an edited volume, The Abnormal Personality Through Literature, by Alan A. and Sue Smart Stone (1966), which presented long passages of great works of fiction to describe psychiatric syndromes and psychotherapeutics. I thought it a great idea then, and still do. The work you are reading attempts to apply their method more specifically, to just the destructive psychological effects of trauma and efforts to overcome them. The other variations from Stone and Stone include the use of shorter passages, and comments on changes in the way trauma has been recognized over the years, since it has been officially acknowledged in the Diagnostic and Statistical Manual (DSM) as the official United States standard.
A reasonably clean rough draft: