Service members of the United States (U.S.) military have encountered countless battles and wars throughout history. Veterans, regardless if they are currently active, have been exposed to a world most civilians are incapable of understanding. The wars in Iraq and Afghanistan have been the longest continued U.S. military operations since the Vietnam era, resulting in more than 6,600 deaths and 48,000 injuries.
Many veterans describe their experiences as positive and rewarding, recounting their ability to readjust into civilian life with minimal difficulties. Unfortunately, there are a number of veterans who do not share the same experience. Some veterans return to civilian life with various health conditions and find readjusting to life at home, reconnecting with the people around them, finding employment, or returning to school is a relentless struggle.
Some of the intrapersonal psychological issues service members face are in regards to how they are trained. They are trained in critical survival skills for a war zone (e.g., being on guard and aware of their environment at all times) and some veterans struggled with their reintegration because of those ingrained skills. For example, a veteran may confuse an item on the street with an explosive or a neighbor could slam their door and they may think it was a bomb. Unfamiliar objects in the street or unexpected loud sounds may conjure up the warzone for veterans. Thus, the survival skills that were highly valued in the warzone can be maladaptive at home and can lead to mental health concerns. A soldier reintegrating into the civilian world may feel like Dorothy in The Wizard of Oz, when she realized the world she knew and understood no longer existed. These personal thoughts are significant when thinking of how veterans are perceiving the new world around them and how they fit into it.
During their time serving, veterans typically experience close social support from fellow soldiers. When returning to civilian life, they may not find the same social support from their new workplace- this may lead to divides or conflicts. A soldier spoke of the reintegration into her civilian job as challenging due to the slow-pace and boredom she experienced. She spoke about how while deployed, she was functioning at a high level, always wondering what could happen, but when she went back to her previous job she felt very little job satisfaction and failed to feel the same camaraderie. While serving, this veteran’s work was fast-paced and involved connectedness and a shared purpose amongst her fellow service members. Her civilian job did not reach that same level of pace or connection. Going from a high-intensity working environment to a low-intensity working environment negatively affected her satisfaction within her job.
While deployed, veterans may feel separated from their civilian friends and family. However, once they are home, they can also feel separated from the close friends they gained during their service. This continuous sense of disconnection from social networks causes psychological distance from the meaningful places and people in veterans’ lives. Some veterans have described their post-deployment social support as difficult and often a solitary journey. Research has shown that veterans with Posttraumatic Stress Disorder (PTSD) are much more likely to report marital, parental, and family adjustment problems than veterans without PTSD. These interpersonal, social aspects are significant in how well veterans reintegrate into civilian life.
A large number of veterans deployed to Iraq and Afghanistan have suffered traumatic brain injuries (TBIs), and many have shown symptoms of PTSD, depression, and substance misuse or abuse. Unfortunately, these service members often have more than one health condition. The most common comorbid health disorders are PTSD, substance use disorders, depression, and symptoms associated to mild TBI. In 2010, almost 300 veterans committed suicide, and about half of those suicides were veterans who had deployed to Iraq or Afghanistan.
Tools & Resources. The frequency of these issues has led individuals to search for possible solutions. Research has shown that expressive writing is an effective tool for veterans- allowing them to freely explore their deepest thoughts and feelings. While this may allow for veterans to express themselves deeply, it is important for mental health professionals to be aware of the possibility of these strong negative emotions in order for them to help these individuals work through them. Exposure therapy is another tool often used to help veterans with mental health concerns. It is an intervention strategy commonly used in cognitive behavioral therapy to help people confront their fears. Prolonged exposure is a specific type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations- which is strongly recommended for the treatment of PTSD.
Although veterans may want to avoid anything that reminds them of the trauma they experienced, doing so reinforces their fear. By facing what is being avoided, they can decrease symptoms of PTSD by actively learning that the trauma-related memories and cues are not dangerous and do not need to be avoided. Another area that has been looked at is the green-jobs training program. The Veterans Conservation Corps (VCC) green-jobs training program is a 10-month educational program that provides academic and vocational training to veterans who are thinking about pursuing environmental careers or green jobs. Research has found improvements in two measures: social functioning and ability to perform daily tasks.
(Sources: Koenig, C. J., Maguen, S., Monroy, J. D., Mayott, L., & Seal, K. H. (2014). Facilitating culture-centered communication between health care providers and veterans transitioning from military deployment to civilian life. Patient Education & Counseling.; Mankowski, M., Haskell, S. G., Brandt, C., & Mattocks, K. M. (2015). Social support througho