Psych 190: Warriors at HomePsych 190: Warriors at HomeReactions to WarReactions to War

Introductory OverviewIntroductory Overview

Dr. Elena Klaw Dr. Elena Klaw

What’s Unique About Veterans?What’s Unique About Veterans? Willingness to put others’ lives before ownWillingness to put others’ lives before own Belief in mission firstBelief in mission first Loyalty as core component of serviceLoyalty as core component of service Experience of camaraderie of unitExperience of camaraderie of unit Experience of reliance on authority and Experience of reliance on authority and

hierarchyhierarchy Stoicism in face of physical pain, sacrifice Stoicism in face of physical pain, sacrifice

and uncertaintyand uncertainty Eschew individual recognition –don’t want Eschew individual recognition –don’t want

to be seen as heroesto be seen as heroes

Coming Home is HardComing Home is Hard Readjustment may mean changing Readjustment may mean changing

reactions and behaviors that were key to reactions and behaviors that were key to survival in dangerous environments.survival in dangerous environments.

The body adapts physiologically to stress The body adapts physiologically to stress and danger and it is hard to just resetand danger and it is hard to just reset

Stress reactions on a continuum & can be Stress reactions on a continuum & can be acute or delayed. Feels like acute or delayed. Feels like ““going crazy.going crazy.””

PTSD comes from experiencing PTSD comes from experiencing helplessness and horror; impairment helplessness and horror; impairment interferes with life.interferes with life.

Signs to get help: suicidality, problems Signs to get help: suicidality, problems eating, sleeping, concentrating, having eating, sleeping, concentrating, having relationships, or using maladaptive ways relationships, or using maladaptive ways to cope that put self or others in danger.to cope that put self or others in danger.

PTSDPTSD Different from combat stress reactionDifferent from combat stress reaction Psychological and physiological changes that Psychological and physiological changes that

result from experiences of helplessness and result from experiences of helplessness and horrorhorror

PTSD if at least a month of symptomsPTSD if at least a month of symptoms Acute if symptoms less than 3 monthsAcute if symptoms less than 3 months Chronic if symptoms more than 3 monthsChronic if symptoms more than 3 months May experience May experience ““delayed onsetdelayed onset”” Hoge 2004 study: 12-20% of Marines & Hoge 2004 study: 12-20% of Marines &

Soldiers in initial OIF ground invasion had Soldiers in initial OIF ground invasion had PTSD PTSD

PTSD Checklist (PCL-M)PTSD Checklist (PCL-M)2 Kinds of Symptoms2 Kinds of Symptoms

Repeated disturbing Repeated disturbing memories, thoughts, memories, thoughts, images of a stressful images of a stressful military experiencemilitary experience

Repeated disturbing Repeated disturbing dreamsdreams

ReexperiencingReexperiencing Upset when reminded of Upset when reminded of

the experiencethe experience Physical reactions to Physical reactions to

remindersreminders Avoiding thoughts or Avoiding thoughts or

activitiesactivities

Trouble rememberingTrouble remembering Loss of interestLoss of interest Feel cut off/numbFeel cut off/numb Feel angryFeel angry DistractedDistracted HypervigilantHypervigilant

Helplessness and HorrorHelplessness and Horror

Experiences involving fear of deathExperiences involving fear of death Witnessing deathWitnessing death Helplessness to end sufferingHelplessness to end suffering KillingKilling Participation in events that cause Participation in events that cause

casualties, particularly involving childrencasualties, particularly involving children Sexual assault Sexual assault Repeated experiences of powerlessnessRepeated experiences of powerlessness

Other ReactionsOther Reactions Normal and common to experience Normal and common to experience

symptoms of anxiety/depression/anger symptoms of anxiety/depression/anger during readjustment.during readjustment.

Loss of camaraderie and loss of identity Loss of camaraderie and loss of identity would be difficult for anyone to handle!would be difficult for anyone to handle!

Depression, anxiety, and anger affect Depression, anxiety, and anger affect concentration, relationships and behavior concentration, relationships and behavior have physical correlates.have physical correlates.

Disorders (DSM) cause significant Disorders (DSM) cause significant impairment and distress.impairment and distress.

At SJSU: Counseling Center 924-5910At SJSU: Counseling Center 924-5910

Negative CopingNegative Coping Acting out (externalizing): e.g. risky Acting out (externalizing): e.g. risky

behavior, substance abuse, aggression behavior, substance abuse, aggression (short fuse)(short fuse)

Withdrawal (Internalizing): Depressive Withdrawal (Internalizing): Depressive thoughts are internal, stable, and global, thoughts are internal, stable, and global, prevent positive coping, lead to isolation prevent positive coping, lead to isolation and inertia.and inertia.

Both increase existing feelings of shame Both increase existing feelings of shame and isolation, damage relationships.and isolation, damage relationships.

Dealing with SymptomsDealing with Symptoms Has nothing to do with will or character!Has nothing to do with will or character! Professional Counseling: U.Counseling Professional Counseling: U.Counseling

Services (924-5910, Admin 2Services (924-5910, Admin 2ndnd Floor), VA Floor), VA Hospital or local Vet Center Hospital or local Vet Center

Can be group or individual, with or without Can be group or individual, with or without medsmeds

Involves having a safe space to experience Involves having a safe space to experience thoughts and feelings so you are not flooded thoughts and feelings so you are not flooded with them (out of your control), or with them (out of your control), or experiencing physical responses, or avoiding experiencing physical responses, or avoiding cuescues

Social support is essential (e.g. class for vets, Social support is essential (e.g. class for vets, VSO, mutual help, family, religious institution)VSO, mutual help, family, religious institution)

Supporting VetsSupporting Vets

Value the unique skills, strengths and Value the unique skills, strengths and vantage points of military veterans.vantage points of military veterans.

Share perspectives respectfully.Share perspectives respectfully. Increase support: VSO, Vet Centers, Increase support: VSO, Vet Centers,

Mutual Help, Counseling Center.Mutual Help, Counseling Center. Educate faculty, staff and peers.Educate faculty, staff and peers. Learn from peer leaders.Learn from peer leaders. Increase opportunities for veterans to Increase opportunities for veterans to

engage in national service and community engage in national service and community building.building.