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Active and experiential therapies, like meditation, martial arts-based movement, symbolic arts and drama, can capture the intensity of emotion and bonding and can lead to healing.
Hurt Locker was directed by a woman, and tells us more than we want to know about the experience of war. Kathryn Bigelow, the director, gets us inside the characters' heads and hearts: What do men talk about as they pull triggers, as they share stories and danger? What is it like to see bloodied bodies and friends hurt?
Hurt Locker is an astounding film nominated for the Oscar award for best picture, director, screenplay and original score. Staff Sgt. William James, played heroically by Jeremy Renner who is nominated for best actor, is an expert bomb disposal expert. He volunteers to go beyond the call of duty into dangerous situations, trusts his instincts, and respects excellence even in the bombs of his enemy. He seems to act irrationally, but survives.
In contrast, the psychologist in the film, acts and speaks rationally...in irrational situations. He is shown to be somewhat clueless as he gives a pep talk to a young soldier who becomes aware of his danger, and tries to persuade Iraqi civilians to move in the road. The psychologist is blown up, the young soldier is, as is foreshadowed, injured, but ......survives.
Yet he cannot make the transition to a peaceful home life. He is shown transfixed in one of his rare moments of indecision as he confronts rows of similar breakfast cereals in a supermarket, a moment of stark contrast with his action in the battlefield.
The film starts with a statement: war is a drug. As Sgt. James keeps bits of deconstructed bombs under his bed, we see that he cannot give it up. After a short visit home, he returns for another deployment.
When pressed about his marriage by his soldier buddy, he cannot speak or explain his emotions. This is a man who is nonverbal, who expresses himself by wrestling with his buddies, gets his girlfriend pregnant and becomes a father without knowing why or how-how could talk therapy work with him?
The problem is, it is precisely what serves him and others in the battlefield-hypervigilence, light sleeping, and impulsive actions-that mark him with PTSD on his return.
How can he-and others like him-make a transition to a peaceful life and relationships?
Most civilians and mental health professionals are like the psychologist in Hurt Locker-we don't really understand the irrational intensity of war and the difficulty adjusting to home life. Hurt Locker does a real service in giving us an insider experience of combat and the journey home.
Following is an article I wrote in the National Psychologist after working with combat vets in Israel that describes the use of active and experiential therapies. It is shown here in text format:
National Psychologist, Vol. 18 No.4
Working with Trauma in Israel: Lessons for America
By Ilene A. Serlin, Ph.D.
We know that we will soon have waves of returning war veterans from Iraq and Afghanistan and witness their adjustment coming home and with their family members. We know that there will be massive psychological wounds to these soldiers and those around them.
Clinical psychology came of age after World War II to help returning soldiers; what can we learn from those lessons that will help us with today's challenges?
Unfortunately Israel has much to teach us about how to work with war trauma. I have been traveling several times a year to lsrael to work with combat soldiers and their families. In the following piece, I describe some of this work and the lessons that can be learned.
These are:
• Trauma is never finished.
• The personal connection heals.
• Trauma is in the body: mind/body methods.
• Posttraumatic growth comes from building resiliency, creativity, hardiness and courage.
•
Trauma is never finished
According to Judith Recanati, founder of Natal trauma treatment center in Tel Aviv, Israel was founded on the myth of "Never Again." Instead of marching silently to the gas chambers, Israel's founding soldiers were mythically heroic, strong and physical. Even with good pensions and a hero's welcome, however, soldiers from the 1967 war are still filling Natal's support groups. Many feel as if their lives are over and they have not found a new purpose for living. The succeeding waves of terrorism at Sderot and other cities in Israel do not strengthen Israel's citizens; rather, they are becoming more vulnerable or hardened (Sertin, 2008). With waves of terrorism worldwide, how will we face cumulative effects over generations (Paulson and Krippner 2007)?
The personal connection heals
Before a soldier begins military service, a staff member from the Casualty Division of the Israeli Defense Force establishes contact with the family and maintains this contact throughout the military service and after the soldier has returned home or has been wounded or killed. Widows have yearly
retreats and stay connected for years. Every town in Israel has a "House for the Fallen Soldier" that keeps track of names and memorials and hosts events for families. Both Selah and Natal are set up like homes with a kitchen on each floor and welcoming staff. The hotline is staffed by paraprofessionals from the community who are older than 40 and know the callers by their first names. A web of connections provides a support system that holds and helps heal the soldiers, family and community members (Serlin,2008).
Trauma is in the body
Trauma is the "speechless terror" characterized, by frozen affect, memory and speech. Methods that re-awaken numb bodies in a compassionate environment are nonverbal and symbolic and include meditation, imagery, an, music and movement therapies, EMDR, psychodrama and existential therapy (Serlin, 2007a).These are being used effectively in Israel along with cognitive and verbal approaches (Serlin, 2007b).
A war widow working in a group wrote:
"When I'm thinking in a retrospective way, I realize now how detached I was from my body. I used it as a tool in order to walk, talk, but rarely as an expressive tool. Only after the first day, I started to connect to my feelings through my body and my movement. Only through participation could I understand the meaning of it and was able to differentiate and name it. As I moved, I felt a growing amount of energy and power emerging from my body. I started to communicate with movement with some other
members of the group."
Posttraumatic growth
Posttraumatic growth comes from building resiliency, creativity, hardiness and courage: Posttraumatic growth refers to the transformative potential inherent in any breakdown (Calhoun and Tedeschi, 1999). It means using methods that foster creativity, build on strengths and establish new narratives of personal identity and hope (Antonovsky, 1979; Frankl, 1959; Mastow, 1962; Pennebaker, 1990; Serlin and Cannon, 2004).
In a group that took place during the war in Lebanon, a participant's son was called up to the front. She wrote:
"It was a time of war, a time of fear, a time of a lot of anxiety....We talked about death a lot and I cried a lot and I was invited to tell about my feelings. The group approached me, reaching their hands to me, and we stayed that way for a long time. I started to sing a sad song,.. and the group sang with me. I felt like a small child, a frightened child but at the same time a child with a protective mother, a containing mother. I could feel the energy flowing into my body. I also felt part of a "oneness" as I felt the energy of the group. I was not alone anymore. First I could feel it physically and then I could process it emotionally. I was never held like this by my mother and it felt so good. It helped me realize once again ... the importance of nonverbal communication and also the strength of the group. It gave me hope again."
Conclusion
The Israeli experience working with trauma car help psychotherapists understand the importance of the ongoing cumulative effects of trauma, the importance of the personal connection, the centrality of mind/body methods and the potential of posttraumatic growth.
References
Adonovsky, A. (1979). Health, Stress and Coping. San Francisco. Jossey-Bass.
Calhoun, L. G., and Tedeschi, R. G. (1999). Facilitating Posttraumatic Growth: A Clinician's Guide. Mahwah, N.J. Erlbaum.
Frankl, V. (1959). Man's Search for Meaning. New York. Praeger.
Maslow, A. (1962). Toward a Psychology of Being. Princeton, N.J. D. Van Nostrand.
Paulson, D. S., and Krippner, S. (2007). Haunted by Combat. Westport, Conn. Praeger, Security International.
Pennebaker, J. (1990). Opening up: The Healing Power of Expressing Emotions. New York. Guilford.
Serlin, I.A. and Cannon, I. (2004). A Humanistic Approach to the Psychology of Trauma. In Living with Terror, Working with Trauma: A Clinician's Handbook. Edited by Danielle Knafo. Northvale, N.J. Jason Aronson.313-331.
Serlin, LA. (2007a) Whole Person Healthcare. Westport, Conn. Praeger.
Serlin, I.A. and Speiser, V (2007b). "Imagine: Expression in the Service of Humanity." Special edition of The Journal of Humanistic Psychology. Vol. 47, no. 3. Thousand Oaks. Calil Sage Publications.
Serlin, I. (2008, Fall). "Treating War Trauma in Israel: Lessons for the United States." Trauma Psychology Newsletter, Washington, D.C. American Psychological Association. Vol. 3, No. 3. 10-15.
