It Takes a Community - Page 6

The intense and inherent ambiguities of war are complicated further by the current demands of counterinsurgency tactics, which require warriors to be somehow both friend and foe—at one moment, they're conducting full-combat operations, and in the next, handing out candy and soccer balls. They may be engaged in a variety of noncombat missions with the local people, all the while not knowing who the enemy is. The warrior thus becomes the reluctant diplomat to people, including women and children, who, if she lets her guard down, may try to kill her.

Today's wars are increasingly fought and supported by women warriors, even though there's a lag between current legislation prohibiting women from being in combat roles and the actual roles women are playing. Although women may perform the same duties as men, including fighting, their unrecognized status may detrimentally impact credit for the risks they take and disqualify them from receiving awards and services as veterans.

The incidence of gender-based violence, commonly referred to as Military Sexual Trauma (MST), is another disturbing factor in today's wars. According to our interviews with female veterans, there's secrecy and shame about being a victim of MST, along with fear that reporting it will damage opportunities for advancement or add to the risk of combat. Because of warriors' dependency on others in their units, especially those superior in rank, MST can be experienced similarly to childhood sexual abuse by a trusted family member, engendering commensurate feelings of shame and distrust of others.

A New Vision

So a kind of "perfect storm" is brewing: we have a large and growing population of war-weary troops and veterans; a mental healthcare system lacking the person-power to treat them; and conventional professional therapeutic approaches that fail to recognize the uniqueness of military culture and trauma. Current clinical interventions like CBT, EMDR, and Exposure Therapy may be helpful to many of those who seek assistance, but even if enough therapists and mental health facilities were providing these treatments, many individuals would miss out on help because of stigma, cost, fear, distance, or the unpleasantness and intensity of the therapy. Understandably, many active military and veterans resent being labeled with a psychiatric diagnosis, regardless of how their symptoms are categorized in the DSM. They don't want to be, nor should they be, pathologized for having done what they deeply believed was their duty and later suffered disproportionately for it.

A critical shift is needed in how we think about the challenge of helping so many struggling young men and women. Traditional methods that rely primarily on professional practitioners operating within the mental health establishment can't respond to a problem of this scale. We need to provide healing alternatives that build on the resiliency of the human mind-body system, rather than assumed pathology. We need to do this—at least as a first line of approach—within a nonclinical community setting that won't alienate these clients or make them feel worse, while taking advantage of local organizations, peer-group support, and family participation. But how do you create this public health-oriented treatment mode, which includes trained nonclinicians?

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