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More Tips for Treating Soldiers – A Few Don’ts

07 Feb

Hello again,

Well, last week, we gave the outbrief to Commanding General Halverson at Fort Sill, and held similar meetings with the brigade commanders and unit leaders of the soldiers who were our subjects.  We got a lot of great feedback and an impressive amount of receptivity.  

We also got to do in-depth interviews with a dozen of the soldiers who were in the study (minus their name patches and insignia, to ensure total freedom of speech). The information we got from all of these meetings filled in the gaps in our understanding of the research data – hugely helpful.  I’ll be reporting more on that very shortly. 

For now, suffice it to say, the guided imagery helped enough Soldiers to warrant ordering them to listen to it, even with the initial – and sometimes ongoing - antagonism engendered by making it compulsory. 

Special thanks to COL (R) Jill Chambers of This Able Vet for coming with me on her own time, participating in the meetings and interviews, translating acronyms and Army practices at a jaunty clip (some new ones that stuck: PCS is Permanent Change of Station; an SIR is a Serious Incident Report -- for someone like me, it’s like learning a whole new language!), and for just being her incredibly enthusiastic and supportive self.

She couldn’t get over how open, welcoming and responsive the officers at Fort Sill were to us and our touchy-feely intervention.  She was also impressed with how psychologically sophisticated several of the officers and NCO’s were – heavy duty smarts and excellent leadership training going on there, good people.

At each meeting, Jill told the story of how she was at the Pentagon on 9/11 (Special Assistant to Admiral Mike Mullen for Returning Warrior Issues) when it got hit, how she spent 9 years having nightmares of being chased by a fiery plane, then got introduced to our Healthful Sleep guided imagery, and after listening to it for 2 weeks, never had that nightmare again.  By telling her story, she made it easier for others to be more comfortable with theirs.  Totally awesome.

Okay, back to our treatment tips for civilian therapists who work with the military, based on feedback from several not-too-happy service members who devolved into “Behavioral Health Failures” as the result of getting some pretty clueless therapy.  

Last time we offered a long list of Do’s.  Here are some equally important Don’ts:

  1. Don’t compare combat trauma to civilian trauma – even though there are some aspects of PTS that are the same, this will not inspire trust or confidence – this will make them angry and/or convince them you don’t have a clue.

  2. Don’t get caught up in your curiosity about whether they killed anyone and if so, how many.  Allow them to talk about this if and when they want to.

  3. Don’t be in a hurry to push meds or up their dosage – there’s way too much of that already going on, and there’s a reasonable chance that this person is already overmedicated.

  4. Don’t say you understand if you haven’t been there.  You might in fact understand a lot, from just having done a lot of work with warriors, but if you have no combat experience, put a lid on it anyway.

  5. Don’t make assumptions – ask more questions and keep on listening.

  6. Don’t bring your politics into the conversation, whether pro or con.  You’d be amazed by how many therapists do this. This is your issue, not theirs.  To a warfighter seeking help, it’s irrelevant and annoying. (As you may have gathered by now, a lot of things are annoying!)

  7. Don’t ask the normal intake questions about childhood history, unless it’s brought up. This too is mostly irrelevant, given the recent history of having been downrange, with all its attendant intensity and drama.

  8. Don’t use the “D” in PTS and don’t call them “wounded warriors” either.

  9. Don’t flash your resume or credentials unless you’ve been asked for them. Otherwise, chances are you’ll be doing that to reassure yourself, not your patient.

  10. Don’t offer false reassurance that they’ll be as good as new in short order.  Maybe so, maybe not. But one thing for sure: they will not be the same. They can be OK and grow into their healing in ways that may be even better than before, but chances are this will not be simple or easy, so don’t make promises you can’t keep.  

Okay, that’s it for now.  Please feel free, as always, to add to this list by posting your own hard won practice wisdom below.

Take care and be well.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award