Mental health and the military

Although most people probably associate psychological problems amongst the military with post traumatic stress disorder (PTSD), those serving in the forces can suffer from a whole range of problems including anxiety, depression, drug and alcohol abuse, psychotic illnesses, and relationship problems.  And it is not only about currently serving personnel, but also about service veterans.  In fact, in many ways the latter have more problems because they tend to be more ‘invisible’.  Furthermore, a lot of mental health problems do not materialise – or at least not to the extent that the individual seeks help – until many years after discharge.

There is no doubt that the psychological health and wellbeing of serving combatants, who are the ones most likely to be directly traumatised, is taken far more seriously nowadays than it was even 50 years ago – and even then things were a lot better than they were 50 years before that. The plight of military veterans leaves more to be desired, although organisations such as Combat Stress do a great deal of therapeutic and supportive work with veterans of all ages.

There is now a general acceptance that people in combat situations (which includes civilians as well as military combatants) experience things which most of us will (hopefully) never have to endure.  Somewhat ironically, though, this is one of the reasons why so many veterans find it hard to talk about their experiences to ‘outsiders’, including therapists.  They (rightly) feel they have seen and done things which most people would simply not understand.  This is one of the reasons why veterans in particular can leave it so long – sometimes decades – before seeking help.  In the meantime they simply endure the flashbacks, anxiety attacks, bouts of depression, drug and alcohol problems, relationship break ups, and so on that can all be associated with their experiences whilst in service.

With regards to treatment, there are a range of psychological therapies on offer, many of them based on some form of cognitive-behavioural type therapy. These therapies can not only be used to treat PTSD, but also some of the other problems experienced by service and ex-service personnel, including anxiety and depression.  And it has to be said that there is undoubtedly much value in many of these therapies, particularly in the sense of alleviating troubling symptoms and providing the clients with a supportive and safe environment in which to express their thoughts and feelings.

However, what seems to be missing from these approaches is any real exploration of meaning – and the limits of meaning, in the lives of the individuals who have undergone such harrowing experiences.  This has the unfortunate side effect of medicalising or even psychologising the experiences of these individuals. In other words, they are seen as having a medical/psychological problem which needs to ‘solved’ as soon as possible – and often this is exactly how the individuals themselves view the situation. Although this desire for a quick resolution is perfectly understandable, in many ways it is, at best, only a partial resolution.

There is no real exploration or validation of that individual’s (unusual) experiences; no exploration of what it means to be in combat; to undergo the rigours of military training; no understanding of what led that particular individual to join the forces in the first place; no understanding of what it means to leave the protection of a structured life in the forces and to be left with only memories – good, bad and fractured.   Nor real appreciation of what it is like to be shunned by the wider society because no-one wants to know about the kinds of experiences the individual has endured.  No appreciation of what it is like to suffer in silence.

On the other hand, a more exploratory and open ended approach to therapy is far better positioned to engage with such issues.  This is because it takes such experiences seriously; because it is prepared to accept that they may be very important for the individual in question.   And because it is prepared to give the individual the time and space to explore the meaning of such experiences in their own way.

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