Prudence Gourguechon, M.D.

Prudence L Gourguechon M.D.

Psychoanalytic Excavation

The Art of Overcoming Obstacles

Removing obstacles decreases hopelessness which just might cut military suicides

Posted Feb 26, 2013

From time to time I entertain myself—and try to discipline my thinking—by attempting to come up with one-sentence descriptions of psychoanalysis. I figure that reducing complexity to simple understandable words is a tribute to the richness of the ideas, not a disparagement of them. Here’s one of my attempts:

Psychoanalysis is about getting rid of unconscious or unacknowledged obstacles to living a good life.

Keep this in mind as I make a jump to a recent announcement from the White House.

Following from my own interest in what we as a civilian population can do to make the transition from wartime to peacetime, and in the process welcome home our service members, I’ve been an admirer of the Joining Forces initiative started by Michelle Obama and Jill Biden. 

This is a program designed to encourage a robust and effective civilian response to the post-war lives of those who have served in the military and their families. 

On February 25, 2013, Joining Forces announced a challenge to the national’s governors—as returning service members and military families come home and try to build peacetime lives, they need good jobs.  And if they’re credentialed in the military as a paramedic, or doctor, or an electrician, or a truck driver, or licensed in one state or another, then please make those licenses and credentials transportable across state lines.  A simple thing conceptually, but probably pretty complicated to bring about.  I imagine it would take 50 state laws to override state-specific licensing requirements.

I read this press release and thought what a good idea, and how easy to overlook.  There must be hundreds of hidden obstacles to service members and their families—the first lady’s office says to expect a million military personnel returning to civilian life in the coming years—setting up lives with connections to jobs, healthcare, schools, and communities.

That’s what made me think of my one-liner definition of psychoanalysis, which devotes itself to exposing and neutralizing hidden obstacles to a good life.  (Yes, I know, a lot of therapies could be described that way, not just my personal brand. But that’s not my subject at the moment.) 

Meanwhile, the epidemic of suicides among service members and veterans has not abated.  The causes are complex, the solutions probably more so.  But with 30 years of clinical experience, I know that hopelessness—intense, loaded, desperate hopelessness, in the moment—is a major contributor to suicide.  Prevent hopelessness and helplessness and we can do something to reduce suicide. 

Focus on hopelessness reduction.  Identifying and removing obstacles to our veterans and their families living a good life back home—including something as simple but vital as decreasing red tape and bureaucratic hassles—may be a crucial public health intervention.

What other unseen obstacles do military families face as they start or revive civilian lives?  I hope they will inform us. The hassles must be enormous.  I’ve noticed that some corporations are offering discounts on hotel rates or checking accounts.  I hope that continues, because, small as the monetary value may be, it may be these tokens of appreciation and recognition will buffer some of the frustration families face. 

While we try, as a society, to identify and uncover hidden obstacles, we also need to work to make our military personell visible  to us, the civilians.  It is so easy, in this war with no draft, no real common purpose, to forget, to want to forget.  But if we do disavow the fact that our country has been at war for over 10 years, we will see ongoing, terrible psychological damage back on our shores.

One place to start is to ask a simple question as part of every clinical history.  Every therapist, doctor, nurse should ask –have you or someone in your family served in the military?  A wonderful and poignant editorial by Dr. Jeffrey Brown in the Journal of the American Medical Association, (JAMA, November 14, 2012—Vol 308, No. 18) makes the case for asking “The Unasked Question”  in a way that is unforgettable.

About the Author

Prudence Gourguechon, M.D.

Prudence Gourguechon, M.D., served as President of the American Psychoanalytic Association from 2008-2010. She has a clinical and consulting practice in Chicago.

More Posts