Always a Soldier Presented by

Alicia Bogard, MSW, LISW-S, CFLE

IntroductionCultures of WarCompassionCommunicationConclusion

Outline

Are you a Veteran?

Loved one a Veteran?

“I do not want to be dependent on anybody. I developed this belief the day that I joined the Marine Corp. “Once a Marine, always a Marine.” It is important to me to remain stoic. I do not believe in crying and if I have to then it will be in private. I am not sure if it serves a purpose, but feels like it is cowardly to do.” * Vietnam Veteran

Branch of the Military (Army, Marines, Air Force, Navy and Coast Guard)

Draft vs. Enlisted

Not Stereotyping

Cultures from Each War…

Differences to Consider

World War II:

◦ Heroes and Praised.

◦ Did not speak about what happened

◦ “Shell Shock”& “Combat Fatigue”

“During the war,

I earned a lot of metals, but did not speak about them because I

did not want people to know

what I did. “* World War II Veteran

Cultures from Each War

Korean War:

◦ Viewed a “Conflict”

◦ Not supposed to be any wars after WWII

◦ Feel overlooked

“ and when the war was over, the Chinese military puts their guns down and wanted to shake our hands because they called a truce.”

* Korean War Veteran

Cultures from Each War cont.

Vietnam War:

◦ Media Coverage

◦ Divided Country

◦ No gratitude or appreciation for veterans

“Being in Vietnam, I

believe was a waste and there was no reason. “ * Vietnam Veteran

Cultures from Each War cont.

Gulf War/Dessert Storm Veterans◦ Exposed to nerve

gas◦ Increased rates of

brain cancer, lung cancer, debilitating chronic diseases and pain, increased risk for Alzheimers

Iraq/Afghanistan Veterans

◦ Struggling when they return to civilian life

◦ Job skills do not translate from military

Cultures from Each War cont.

Person came home a different/changed person◦ Veterans returned home & their family told

them they did not know or recognize them Veterans worried about their family finding out

what they did/had been through

Rape in Military/Conceiving Children

Substance Use to Cope

Family Dynamics

Family Dynamics cont.

“ I left my family because I went to get milk and never came back.”

* Vietnam Veteran

Domestic Violence due to still being in “combat mode”

Being military family is a different lifestyle◦ Stoicism◦ Different Lifestyle (traveling/changing roles)◦ Loss of Friends (technology not the same)◦ Concern about Pensions

Post Traumatic Stress Disorder (affects them in large crowds, ability to keep jobs and relationships, interactions with the law)

Veterans can have a distrust of any authority

Co-morbid conditions are often present (anxiety, depression, substance abuse, social or family issues)

How Does This Effect Us as Professionals?

Addressing all areas of health: Spiritual, Emotional, Social,

Physical & Cognitive

Looking at possibility that physical pain can be related to underlying pain in other areas

Holistic Approach

Forgiveness Issues

Isolation

Guilt

Guided Imagery

Use Ritual to help bring healing (memorial rocks, pinning, bracelets, letters to the living or the dead)

Compassion

EMDR returns information processing to normal, the memory is still there but it is less upsetting, less intense, less stressful

EMDR is a eight-phase integrative treatment approach

EMDR uses bilateral stimulation(eye movements, taps, audio tones) to reprocess information, which appears to be similar to what occurs naturally during dreaming or REMsleep

EMDR

“There are not documents for

everything I went through, but you do not dream up stuff

like this.” * Vietnam Veteran/P.O.W.

Communication with Veterans IS different than other patients you serve

Veterans are trained at a young age how to communicate the necessary and hold everything else in

Stoicism

Triggers

Communication

Do NOT ask if they are veteran. ASK if they ever served in the military.

Do NOT assume- not all veterans view their military experience as negative. ASK THEM.

When asking if they are in pain- ask if they are “uncomfortable” as many veterans will not admit they are in pain.

Ideas when Communicating

Lead in questions about other topics to develop trust

Some military leaders believe the word “disorder” makes soldiers reluctant to ask for help- they would like to change the name to Post Traumatic Stress Injury

This is a debate if the military environment needs to change and not the disorder.

Be present and have time to listen when Veteran does open up – this may take time

Ideas when Communicating cont.

Conclusion

Bolte-Taylor, J. (2008). Stroke of insight.

DMS-IV- Diagnostic & statistical manual of mental health disorders 4th edition.

Grassman, D.L. (2010). Peace at last: Stories of hope and healing for veterans and their families. Vandamere Press: Florida.

References

Koepell, Barbara. (2015). U.S. Nerve Gas Hit Our Own Troops in Iraq. http://www.newsweek.com/how-us-nerve-gassed-its-own-troops-then-covered-it-317250

McKay, Heather. Dementia Care for America’s Heroes.

Padin-Rivera, Edgardo. Post Traumatic Stress and End of Life Concerns.

The Hospice-Veteran Partnership of Ohio Fact Sheet 2010

References cont.