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.
In 1992 an extensive survey was sent to the 1200 clinicians Francine Shapiro had trained asking about their clinical experience with EMDR. EMDR was new and it would take a while before many randomized controlled studies would be available (actually there were very few RTCs of method of therapy for the effects of trauma then), so it seemed important that there be information available about the effects of EMDR from independent sources. In addition there was the important, and not often seen, body of clinical “lore” that would be based on a systematic collection of data, not just the passing on of clinical impressions, which is/was a common way clinicians receive our information. So, here is the survey presented at The American Psychological Association Annual Convention (August, 1994) “Eye Movement Desensitization and Reprocessing (EMDR): A Quantitative Study of Clinician Impressions of Effects and Training Requirements” and as published in the now out of print first edition of Shapiro’s basic text, Eye Movement Desensitization and Reprocessing (1995).
This paper comes out of discussions of issues addressed in meetings with combat veterans in the Stress Disorder Treatment Unit at North Chicago VAMC, now named The Captain James A. Lovell Federal Health Care Center.
The Short Version:
The main psychological challenge while in combat is to, minute by minute, find courage to overcome fear and pain. The main challenge of civilian life is to find wisdom to define and meet long term goals. Knowing this is a big step toward overcoming the problems which come with mistaking civilian challenges for combat challenges.
The Long Version:
