Paula J. Caplan Ph.D.

Science Isn't Golden

The Silence That Kills

Time to Break Dangerous Silence about What Veterans Need

Posted Aug 09, 2011

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©2011 by Paula J. Caplan               All rights reserved

Time to Break Dangerous Silence about What Veterans Need

I came late to learning what war veterans endure, but in the seven years since I started listening to them and watching how the rest of us respond, I've become aghast at our silence in the face of their pain. As the numbers show, it's a silence that kills. It kills them literally through ever-increasing suicide rates, more vets dying by their own hands than by enemy fire, and it kills their souls and, in little dreamed-of ways, our own. Still worse is the way that the institutions and individuals tasked with helping are actually, eerily promoting that silence that conceals the disorientation, fragmentation, and devastation that many veterans feel.

Two million veterans of the wars in Afghanistan and Iraq now live among us, some of a total of 23 million from all United States wars. And anyone who believes that those from earlier wars, even World War II, no longer suffer from the emotional carnage of war and what for many were the traumas involved in coming home is wrong. The disconnection of most civilians from veterans' pain disconnects us from profoundly important truths about the nature of humanity and connection.

Ninety-three percent of Americans have never even served in the military, and since veterans tend not to tell us what they have gone through, and we tend to avoid knowing, because war is upsetting, and we mistakenly believe that only trained therapists can help. In fact, we mistakenly believe that therapists are taking care of the problem. We long to believe that therapists can undo war's emotional carnage of war, because then the rest of us don't have to think about it.

Americans might be forgiven for believing that government agencies for military personnel and veterans are doing it all, but two recent, major pieces of evidence show that this is not true. The 9th Circuit Court of Appeals recently ordered complete overhaul of the Veterans Affairs' mental health system, calling it "shameful," guilty of "unchecked incompetence," plagued by "egregious" delays. And a new report from the Government Accountability Office shows that its investigators of the Defense Centers of Excellence - created in the wake of the shocking exposé of mental health care (including both neglect and abuse of patients) at Walter Reed Army Hospital - could not determine how or if the DCOE are carrying out their mandate to help war-traumatized veterans or even how their funding is spent.

What to make of the New York Times piece coming hard on the heels of these reports, in which gentle words of laypeople answering the phones at one VA crisis hotline were presented as evidence that something really good is happening in the VA system? These responders, the writer said, tell people how to "get care," which means finding therapists. Although this may seem innocuous, it perpetuates the notion that getting a therapist is all they need. Were that the case, then given the rates at which the military and the VA have hired increasing numbers of therapists during these current wars, the suicide rates would not still be increasing, nor would the rates of homelessness, family breakdown, and substance abuse, all of which continue to rise.

Even well-meaning people who say that civilians should thank veterans for their service show an innocence about what effects that act can have. Some veterans appreciate it, but others have deep emotional and/or moral conflicts about what they did during their service. When simply thanked by someone who has not asked to hear their story, many feel ashamed and distanced, and this is often true of both those who regret some of what they did and those who think they did not do enough (saved three buddies from an IED, but failed to save a fourth).

The silence that we must break is about this indisputable sequence: The military puts new recruits through ten weeks of basic training to prepare them physically and psychologically for combat, immerse them in a rigid hierarchy, engraining close bonding with others and inculcating instantaneous responses designed to defend, attack, and destroy. There follows lengthy, advanced training that is often combat-focused. Then, for so many these days, come from one to a great many deployments to combat zones. When they come home, nothing that the military and Veterans Affairs (VA) offer of retraining for civilian life remotely approaches either the length or intensity of all of that military training.

Very little is known about how to achieve the reorientation and acculturation to the vastly different close relationships and interactions with the wider society that characterize "home" in contrast to those in the military and combat. One Native American practice involves a period of explicit addressing with homebound warriors of the need to decompress and re-enter the very different civilian society of family, friends, and work. But the vast majority of veterans have no set of rituals and discussions remotely approaching this Native American one.

Indeed, who would implement such a practice and break the silence? Those in the military are in the best position to understand what is needed, but for the armed forces and the VA, having to acknowledge explicitly that military training has rendered millions of men and women unfit for civilian life would risk undermining the military system.

As for politicians, no identifiably powerful minority of them currently speaks this truth. Those who support current and past wars are not likely candidates to blow the whistle, and those who oppose either particular wars or war in general risk being called unpatriotic if they speak up.

What about mental health professionals, to whom in this country we tend to turn for the answers to virtually every psychological problem? The common "wisdom" among them, as among most Americans, is that servicemembers who have trouble coming home are mentally ill; that is, their problems come from within them rather than from the vertiginous leap from experiences of maiming, death, loss of innocence, and confrontation with moral and existential conflicts to expectations of them as civilians at home. For therapists to speak out about this massive culture conflict as an explanation for much war-caused suffering would be to acknowledge that what they have to offer may be quite limited. Some therapists like to believe that they can help anyone, and some are deeply motivated but devastated to recognize the limitations on what they can do.

One might expect communities of faith to help unmask this culture conflict. That few such communities have taken on this mantle perhaps reflects, at least in part, their conscious or unconscious feelings of helplessness to effect the changes that would be needed on such a massive scale. Perhaps the same applies to the mental health professions.

It's time for all to break the silence and make this a war-literate nation. One civilian chatting at a cocktail party can take every opportunity to bring up the clash of cultures, to note how difficult it is even for non-military people to become accustomed rapidly to a dramatically different set of customs, goals, and values than those in which they have been immersed. Above all, let us each listen nonjudgmentally to veterans tell their stories as a way to help truly bring them home from war.

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