As many as one-third of soldiers returning from Iraq and Afghanistan will have troubling psychiatric symptoms or Post-Traumatic Stress Disorder.
An unprecedented number of Iraq and Afghanistan combat war veterans are seeking PTSD therapy, but so many others will suffer in silence.
Soldiers are Used to "Toughing it Out" Instead of Treating PTSD
Combat soldiers are highly skilled at “toughing it out” whatever the problem is. They are trained not to reveal anything that may be perceived as a “weakness.” The word weakness is in quotes because, PTSD, anxiety and depression in soldiers is not, in fact, a personal weakness. Combat war veterans sometimes judge themselves as being weak because the condition makes them feel weak.
Just because a person feels weak, that does not mean that he or she is weak. But for the Iraq war veteran, this feeling of weakness is uncomfortable and he is trained to respond to real or perceived weakness by toughing it out. It seems like toughing it out will offer a sense of control and a feeling of strength to combat the uncomfortable feeling of weakness. Soldiers may be used to solving most or all problems this way.
Toughing it Out Can Help in Treating PTSD but Not if it Prevents the Soldier from Reaching Out
The ability to tough it out is a skill that is absolutely necessary when it comes to a combat situation. When skills like toughing it out are utilized for good repeatedly in life and death situations, setting them aside can be extraordinarily difficult. Soldiers are reluctant to give up skills that work and that have made it possible for them to come home alive from war.
Soldiers should consider that while toughing it out is an essential skill in war and in many other situations, it is not the most helpful approach to dealing with mental health. At certain times during recovery from PTSD, anxiety and depression, it can be helpful to employ these skills, but it is not helpful if the skills prevent the soldier from seeking advice and help from a competent mental health professional who can help the soldier develop an effective treatment plan.
It might be helpful for combat veterans to overcome this obstacle to treatment by thinking of it this way: soldiers should not let go of their ability to tough it out, they just can choose to momentarily have the strength to set it aside, because reaching out would be more helpful than toughing it out in this instance.
If understanding things in this way is what it takes to see a mental health professional, the war veteran might explain to the mental health professional that this is what it took to get oneself into his or her office. This way, the professional can be better attuned and will be less likely to assume that the soldier feels comfortable being there. It is important to choose a mental health professional that one feels comfortable with, and who has experience with war veterans.
PTSD Recovery and Toughing it Out
During recovery, but also in life, there will be times when toughing it out will be needed and necessary. In many situations, the family will depend on and benefit greatly from the veteran’s ability to tough things out and help others to do so. But for right now, setting it aside can be the much healthier choice. This is not the same as being weak or not having the strength to tough it out. Choosing to consciously set this skill aside temporarily, comes from a position of strength, not weakness.
Recovery will be about breaking the habit of using the skill of toughing it out in a knee jerk reaction all the time and in every situation. It will help the Iraq war veteran decide instead which situations require this type of reaction and use it accordingly.
Is There a Stigma in Seeking PTSD Therapy?
Of course, many people, soldiers or otherwise, do not seek mental health help because of the stigma attached to mental health problems. The stigma was most prevalent in World War II but as understanding increased that has changed. can persist in some circles even though we now know that things like psychiatric symptoms often have genetic links and a biological basis.
Soldiers need to consider that PTSD and anxiety are the body’s attempt to protect itself and function under extreme and dangerous conditions. It is a functional reaction to the dysfunctional situation of war. The human body is designed this way, it is not a weakness or a flaw, even though it can cause discomfort.
Once home, it is time to find ways to overcome it and feel and function better. In fact, "the military has been in the forefront of trying to secure services for veterans and is making more of an attempt than ever to encourage soldiers to seek treatment," according to the National Association of Social Workers New York State Chapter’s March 2009 newsletter Update, Vol. 33 – No. 5.
Is PTSD a Vietnam Problem?
Another reason cited by Iraq and Afghanistan war veterans for not getting help is that many of them see PTSD as a Vietnam problem, and do not wish to see themselves as affected by it, even if they are.
They feel this way in spite of the fact that some have called PTSD the “signature disability” of the Iraq war because of the nature of the combat. PTSD can result from any dangerous or abusive situation, it is not unique to Vietnam.
Sources:
The statistics and information cited in the first and last paragraphs of this article are from the article: Bringing the War Home by Cecilia Capuzzi Simon, that appeared in the January-February 2007 edition of the Psychotherapy Networker Vol. 31 – No. 1.
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Lisa C. DeLuca - Lisa C. DeLuca is a psychotherapist/social worker who works with families and teens. She also treats panic and anxiety disorders.
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