Opinion

Now, civilians are experiencing the same kind of crisis stress that is well known to military veterans

How is the veteran community reacting to the new coronavirus threat?

It’s a question that cuts to the heart of the long-term impact of exposure to life stressors and trauma.

Life stressors can be sudden, huge changes in one’s previous way of life — changes like getting a new job, moving to a new city or taking on a new role. The process of transitioning into and out of the military allows me to state with confidence that all who serve in the military have encountered significant life stressors at least twice in their life. I do not make the assumption that all veterans have been impacted by trauma — but many have, whether in childhood, or during their time of military service.

Working as a psychologist with a caseload of several hundred veterans, I have noticed that the relationship between past trauma and future challenges is not a simple one. Even among those with deep scars from childhood trauma, there can be an “inoculation” effect at play. In other words, when future challenges arise, their attitude is “I’ve dealt with worse, and I know that I can adapt to anything.” Such individuals are not ambushed by waves of anxiety — they generally drop into action mode and use our sessions to come up with strategic ways to overcome the challenges in their lives.

So it was with a group of about ten Marines that I joined for a retreat last week. These warriors formed a cohort of “The Sparta Project” — a program which addresses post-traumatic stress from childhood and any military trauma, as well as moral injury and survivor guilt. In the middle of the program, events outside of the “retreat bubble” started to make it hard for us to maintain our focus. Flights were cancelled. Shelter-in-place orders were issued. The support staff at the retreat center suddenly left. Some of these Marines had flown in from far away. In the same week as this retreat, several of those present received traumatic news — the death of a beloved brother who was KIA in Iraq last week, the loss of a friend to suicide, a serious escalating health condition of a loved one.

Given news of this kind, there was every reason to throw in the towel and quit the program. Yet, all who were present — when given the choice — opted to stay and finish the program. Flights were changed when possible, Marines made arrangements to room with a local Marine in the case of travel delays, and we finished strong. Their response to crisis was one of relative comfort and confidence. Some even observed that perhaps America would now feel a bit less alien to them. Why? Because now many Americans are experiencing thoughts and feelings similar to what many in the group have felt for many years. After the retreat, the group has continued to stay connected, with humor and expressions of sincere care for each other as we navigate what is unfolding.

Past trauma can also work in the opposite way too. For some of my patients, past trauma made them more vulnerable to feeling out of control with further trauma exposure. This reaction is absolutely understandable as well. Post-traumatic stress can be seen as a largely biological condition, with psychological and emotional components that are maintained by a shift in normal biological functions. This is why emerging treatments like Stellate Ganglion Block hold promise to be game-changing. In other words, after trauma exposure, our baseline functioning may change in dramatic ways. We can become stuck in “fight or flight” mode. Even patients who did not meet criteria for a PTSD diagnosis often had symptoms like disrupted sleep, surges of anxiety, irritability, difficulties concentrating, and a heightened startle response — in other words, the “hyper-arousal” symptoms associated with PTSD.

Independent of a PTSD diagnosis, or not, trauma can lock us into a state of what I call “chronic threat response.” My patients have described this state as “feeling constantly revved up and being unable to throttle down.” Without the right intervention, this can last for years, or even decades, in the case of many of my Vietnam veteran patients. In this state, we are painfully sensitive to further stressors and additional trauma exposures. When new stressors arise, they further add to our sympathetic load. On the psychological side, we fuse new challenges with unresolved past experiences and may feel overwhelmed by helpless frustration. Some of the veterans in my network are responding to COVID-19 in this way. For example, the current shortage of paper supplies is triggering them to recall what can happen when a nation of people go into survival mode.

Regardless of where we may fall on this spectrum of response, what can we do to stay mentally balanced in the next few months? Here are 5 practical things we can all do right now.

1) Anxiety creates tunnel vision. To combat this, we can take the long view. Even if everything returns to “normal” in a few weeks, the fact that schools, academic conferences, sporting events, and arts and recreation activities have been cancelled means that this will be a defining moment in our lives. We can ask ourselves how we hope this event will be remembered 5 or 10 years from now. During the bombing campaign of London, Londoners showed a resilient response. The way they responded has been a source of national pride ever since. How can we respond in a way that will build our strength as a society when this time of trial has passed? Getting ourselves to think in future-oriented ways that align us with our deeper values will help us reduce our anxiety.

2) We can recognize the emotion of anxiety when it arises, but instead of simply just allowing it to overwhelm us, we can analyze it. Specifically, we can ask ourselves: Does this remind me of any other experience in my life? For example, people like myself who grew up in Los Angeles during the LA riots in 1992 may remember being on “lock down” at that time as well. We may experience many of the same initial emotions to what is happening now. Once we make this connection, we can “de-fuse” the two experiences. Unlike the prior threat of the LA riots, whether or not we become exposed to COVID-19 is largely under our control. The virus isn’t lying in wait for us everywhere we move in the world. It is transmitted through other people. As long as we maintain appropriate safety practices, which may include staying home, disinfecting items we bring home, and maintaining social distance when we get essential items or report for work duties, we are likely to be protected from risk.

3) We can be a role model to someone. This is part of being a good parent — our kids are watching us closely right now. What do we want our children to learn about how to manage adversity? If we are not a parent, there are still ways to be a good role model. We can use social media to promote kindness, connection, good humor, and hope. We can start an epidemic of hope in the way that we handle this time of trial.

4) We can develop our sense of awe. Hiking trails are open — we can go out into nature and develop our connection with the natural world around us. We can turn off our devices and focus outward. Developing a sense of awe has been linked in research to happiness and emotional well-being.

5) We can be intentional about connecting with each other. One of the Marines in my circle — Dana O’Brien — has long had a practice of sending a note of affection to a rotating list of people he cares about. Every so often, I wake to a text message from him that reads, “Has anyone told you lately that they love you? Because I do.” It always makes my day. Being intentional about connecting is critical right now. After the shock of this sudden change in our way of living passes, the impact of social isolation may start to take a toll. We can make a list of the people we care about and put a reminder in our phone to send a note of encouragement once a day on a rotating basis. Doing this will help get us out of our own heads, where anxiety can otherwise derail us.

In past decades, there has been a deep rift in the cultural understanding between those who serve in the military and civilian Americans. Yet unexpectedly now, we are facing a situation that could bring us all together if we do this right. During this time of trial, we can remind ourselves that we are all experiencing a collective level of stress and change in our daily lives and we are in this together. We can remember that despite our differences, we are #OneTribe.

24/7 Supportive Resources for Service members and Veterans, and Military Families

VA “National Veteran Crisis Line” for crisis support at: 800-273-8255 or text : 838255 More resources can be found at: https://www.veteranscrisisline.net/GetHelp/ResourceLocator.aspx. This site offers information on the Suicide Prevention Coordinator (SPC) for each state. Contact them directly and get more information about state resources.

Vets4Warriors is a non-profit, founded by and run by veterans, dedicated to military mental health support and suicide prevention at http://www.vets4warriors.com/ or 855-838-8255 for 24/7 helpline for peer support and resources

Realwarriors.net. Getting help early you can stay mission ready. To confidentially speak with trained health resource consultants 24/7, contact the Psychological Health Resource Center at 866-966-1020 or use the Psychological Health Resource Center Live Chat.

Stack Up Overwatch Program (StOP): https://stackup.org/. 24/7 crisis intervention and peer to peer mental health support for veterans and civilians alike.

Tragedy Assistance Program for Survivors. (www.taps.org) TAPS provides 24/7 peer support for all those grieving the loss of a military loved one, regardless of cause of death or condition of discharge. 1-800-959-8277.

Dr. Shauna Springer is a licensed psychologist and nationally recognized expert on close relationships and trauma. Known as “Doc Springer”, she is a trusted advisor for a vast network of veterans, military families and fellow thought leaders. Her uniquely perceptive insights have helped thousands of patients reconnect to hope, strengthen their relationships, and build lives driven by their values. Dr. Springer’s work has been featured on NPR, NBC, CBS Radio, Forbes, Psychology Today, and Military Times. She is co-author of the best-selling book, Beyond the Military, which explores the psychological, cultural and relational aspects of military transition. Her next book, WARRIOR: How to Support Those Who Protect Us brings the worlds of the warrior and those they protect together to shine new light on things that many of us thought we understood: Trust, Stigma, Firearms, The Imploding Mind, and Connection.

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