Military Culture & Relational Cultural Therapy
(This blog was adapted from a paper I wrote in 2021 for Graduate School)
One of the demographics of I would like to work with would be Veterans and service members with PTSD. I received my undergrad from Abilene Christian University in Abilene Texas, close to the Dyes Airbase. The old English buildings would rattle each time a big carrier plane would fly over. I made friends with many veterans and service members in Abilene, that was going back to school after finishing active service. One friend I developed a close relationship with (who served two tours in the infantry in Afghanistan), his friendship helped me understand PTSD soldiers experienced. He helped me understand that is the adjustment back to civilian life that is so hard for most soldiers. He sent me an article from Sebastian Junger, who has been a war reporter for over 20 years "Why Do Soldiers Have Such Extreme Behavior?” Reading this gave me a deeper understanding of veterans.
“Society is asking them to do the most extreme job in the most extreme circumstances and if necessary to carry out the most extreme acts against other human beings… Society wants us to be extreme so is it any surprise that it sometimes spills over in our free time? Being in the army is like being in a giant family or pack and we develop a pack animal instinct. You never leave the army, you just stop getting paid."
The military culture instills certain beliefs that can save your life in combat but do not prepare for reintegration into modern civilian society.
The approach I have chosen is Relational Cultural Therapy. While it may seem puzzling, to choose a therapeutic approach that has roots in feminism, but that is precisely why I have chosen this approach. (Neukrug, 2018, p. 526). Values that “engage in critical discourse regarding sociocultural issues”, and explore how those issues impact our culture and clients (Neukrug, 2018, p. 526). There are eight principles of RCT, that emphasize empathy, growth, and relationships (Neukrug, 2018, p. 527) RCT puts an emphasis on how humankind does not exist in a vacuum but is affected by relational experiences and society (Neukrug, 2018, p. 528). One such relational experience is how the patriarchy has “negatively impacted women”, however, I would also argue how the patriarchy has negatively affected men, by barring men from their vulnerable emotions or asking for help (Neukrug, 2018, p. 528). RCT elaborates the effects of society on people, specifically women, that caregiving and more tender emotions have been naturally embraced but encourage women to lean into more assertive characteristics (Neukrug, 2018, p. 533). Assertive characteristics that are more celebrated in men, specifically military culture.
My hypothesis, by flipping RCT on its head, would help military service members embrace the “binary gender roles” of women will allow them to adjust easier to civilian life (Neukrug, 2018, p. 526). Helping military service members recognize the effects and symptoms of military culture and modern civilian culture will allow service members to feel like they can ask for help, lean into and speak their more tender feelings. Much of my reasoning and desire to work with this demographic is based on personal experience with military servicemen and women, you might have had some very different experiences.
Reasoning
Roughly 10% of military members will see active combat, however, 50% of military members have PTSD and have filed for compensation (Junger, 2016). Twenty-Two veterans commit suicide a day but there is no statistical evidence that correlates suicide and combat (Junger, 2016). So why is this; military culture and modern civilian culture in America could not be more different. Military men and women experience a “tribal closeness” within their battalion (Junger, 2016). Which could not be more different than the individualized and modern society that they are required to integrate into when their military contract is over (Junger, 2016). Contrary to Israel which sees PTSD diagnoses at 1% because everyone is required one year of military service, creating a deeper sense of community and understanding (Junger, 2016). After 9/11, suicide rates among veterans in New York drastically decreased because society understood what military service members have seen (Junger, 2016). “It took traumatizing a society to come together," says Sebastian in his TedTalk (I highly recommend listening and reading the comments, it's very eye-opening) (Junger, 2016).
Military Culture and PTSD create some “incapacitating symptoms”, such as hypervigilance, negative belief in oneself and emotions, prolonged distress, and physiological reactions to trauma-related cues (Guzman, Farjarito, Dela, & Cruz Fajarito, 2017). Synonymous with “traditional masculinity”, military culture discourages the recognition of a traumatic event, holding the belief that “experiencing a traumatic event is emasculating” (Neilson, 2020). Returning from deployment has often been compared to the disorientation and culture shock that immigrants and refugees feel when coming to a new country (Pease, Billera, & Gerard, 2016, p. 83). When soldiers return from deployment they are often in prime employment age, however, lack higher education and military training that does not equate to civilian life. This instills a negative belief, such as lacking a purpose (Pease, Billera, & Gerard, 2016, p. 84). Accompanied by the lack of tribal-like community, these compounding effects put veterans and service members at risk for isolation, depression, and risk of suicide (Pease, Billera, & Gerard, 2016, p. 85).
Limitations
It has been widely researched that Cognitive based interventions are best suited for PTSD and depression. I am not arguing that RCT alone can help veterans and service members but this accompanied with CBT or EMDR (Eye Movement Desensitization and Reprocessing), can help or kick start the therapeutic process and adjust to civilian life.
One challenge I potentially foresee using this RCT with military servicemen, specifically, is that I am a woman. It would take more time to build a mutually empathetic therapeutic relationship between a female therapist and a male service member. On account the of masculinity of military culture many would find it difficult to be vulnerable, on top of that being vulnerable with a female therapist. I also believe that it is a society that needs to adjust to better understand military service members, however, that would be a daunting task.
Application
I wish I knew the things I know now from this assignment when I was in college, so I could have been a better support system for my military friends. There are two specific tools from RCT that I would implement, “encourage discussion about oppression and marginalization” and “encourage empowerment, high self-esteem, assertiveness, and emotional identification and expression” (Neukrug, 2018, p. 532). After a strong relational and mutual empathetic relationship is built, engaging in dialogue about the marginalization and discomfort that military service members experience during reintegration to civilian life could “lessen the experience of isolation” (Neukrug, 2018, p. 532).
Upon outlining sessions in a socio-political context, RC therapists can help clients deconstruct the negative identities that have developed within an oppressive system (Neukrug, 2018, p. 532). Those negative identities could be feeling isolated, a lack of purpose, an inability to ask for help. By encouraging empowerment, self-esteem, and the understanding of the good qualities military culture enforces, honor, courage, loyalty, and integrity (Pease, Billera, & Gerard, 2016, p. 85); can provide awareness, self-acceptance, and a deeper sense of self-worth (Neukrug, 2018, p. 533). “Opening the discussion around understanding how oppression and marginalization have impacted clients’ lives” creates a gateway for clients to acknowledge feelings and experiences they have not been comfortable admitting to themselves before (Neukrug, 2018, p. 534).
I learned from my military friends that they don’t like being told “thank you for your service”, this might not be the case for every veteran and military service member. One very honest response I heard from a military friend to a stranger who said thanked him for his service was, “I didn’t do it for you, I did it for my brothers and so I could get home”. I think this speaks to the isolation and loss of the tribal-like brotherhood that military service members experience during their service. Additionally, the lack of understanding civilians have on the full scope of military service. I also learned what second-hand/vicarious trauma is from hearing many haunting stories. I am ever grateful for what my military friends have taught me and the friendships they provided.
Guzman, D., Farjarito, C., Dela, C., & Cruz Fajarito, D. (2017, May). Understanding Combat-Related PTSD Symptom Expression Through Index Trauma and Military Culture: Case Studies of Filipino Soldiers. Military Medicine(182), 7.Junger, S. (2016, June 10). Our lonely society makes it hard to come home from war. Retrieved October 27, 2021, from YouTube.com: https://www.youtube.com/watch?v=o9DNWK6WfQwNeilson, E. (2020). Traditional Masculinity Ideology, Posttraumatic Stress Disorder (PTSD) Symptoms Severity, and Treatment in Service Members and Veterans: A Systematic Review. Psychology of Men & Masculinities, 21(4), 578-592.Neukrug, E. (2018). Counseling Theory and Practice (2nd Edition ed.). (J. Giganti, C. Benson, & B. Fahey, Eds.) United States of America: Cognella Academic Publishing.Pease, J., Billera, M., & Gerard, G. (2016, January). Military Culture and the Transition to Civilian Life: Suicide Risk and Other Considerations. National Association of Social Workers, 61(1), 83- 88.