There can be all sorts of reasons why therapy can seem unhelpful - not having a good fit with your clinician, not believing that talking about military experiences is helpful, or having problems with money and homelife. In addition to these factors, however, there are two others that stand out.
The first involves the use of psychiatric medications. These turn out to be a double-edged sword. They can be necessary initially to help people reset from overwhelming distress but over the long-term they end up blunting emotional functioning. Why is this important? Part of moving forward from distressing events is confronting emotional reactions and learning ways to resolve them. However, for people who cannot feel anything, this work often turns out to be insurmountable. And when we cannot experience the full range of our emotions, including sadness, anger, or joy, life can turn into a daily grind of just going through the motions. In my work, helping people come back to life emotionally is the primary goal of trauma therapy. Even so, it is essential that veterans not just decide to stop on their own. The withdrawal can be very disorienting and is often confused with a return of depression or PTSD symptoms. It is critical to discuss formal protocols for a slow and gradual reduction in medication use with your prescriber to give your mind and body time to adjust.
The second factor comes down to the central importance of supportive social networks in trauma recovery. Somewhat unfortunately, most standard trauma therapies are individual in nature meaning that veterans meet one-on-one on a regular basis to discuss problems. Yet, for many veterans they count their clinician as the only person who they talk to and otherwise spend their lives alone. They do not communicate with their spouses or family members about how they are doing, and they avoid other veterans and community groups. While this may seem safe and predictable, the result is often loneliness and a lack of meaning in life while continually talking privately with therapists about the past. Moving forward comes with the challenge of taking risks of connecting with other people. Meaning and purpose often comes down to believing that we are relevant in bettering the lives of other people by what we do.
John J. Whelan
John J. Whelan, Ph.D., is the author of Going Crazy in the Green Machine, available now on FriesenPress.