The First Step: Get Them to Talk

I have worked with combat veterans for a while, mostly Marines and Navy Corpsmen with PTSD and related issues, and it occurs to me that there are two kinds of “messed up” they come home with. The first is PTSD (and, by the way, I don't believe there are PTSD experts: we're all still students of it) but the second kind comes from the ever-changing rules of engagement which have become progressively more complex as objectives became more political than military

Under the current rules of engagement (as opposed to those applied during invasion or in the early days of occupation), a Service Member can witness  comrades being hurt or even killed yet have to wait for certain criteria to be fulfilled before responding with force.  That waiting can go beyond harrowing into agonizing.  So troops can come home with not only the tell-tale thousand yard stare but with an aggravated sense of unfinished business, survivor guilt, mistrust of leaders and visceral frustration and rage.

The first step? Get them talking about it. All of it.

Andrew S. Berry, Ph.D., Psy.D., ABPP is board certified in both clinical and counseling psychology, and a psychoanalyst. He works in a group practice in Clifton Park, NY.