by Dr. Samantha Case, Psy.D. CCPT
When I have been asked to speak or write about a clinical perspective of the effects of Combat Trauma, I tend to approach it very softly and generically. I never want to get graphic or real, as I do not know who is listening to the podcast or reading the articles. If the examples are too raw, they may trigger someone, and I do not know if they have the social support to process it. I know that these individuals have been triggered several times that day and that this material is not unique. However, I do stay vague to reach a broader audience. I hope that any information that I provide encourages them to reach out to a mental health provider.
The examples or coping skills are often ridiculous, and this is done on purpose. Discussing real-life scenarios on a public platform is not only grossly disrespectful to the events that occurred, but also a disservice to those people who survived them and who are reminded of them daily.
The impact of a traumatic event is somewhat defined by various emotional responses, ranging from depressed moods, anxiety, isolation, not sleeping, and not connecting to the world. After experiencing trauma or multiple traumas over an extended period, you can’t come back to the world unscathed, and you should not. The feelings after the trauma are normal responses to a ‘bad event’. You are supposed to feel sad, and angry, and distraught; it becomes a problem when these feelings affect your quality of life and those around you. You are allowed to be depressed or anxious about something that you had no power to control, but when you don’t spend time with your children, family, or spouse, it becomes a problem.
The mental health awareness flyers are out there, the generic commercials are on the radio about mental health awareness and suicide hotlines, which seem to represent black and white, only one extreme or the other. Either you are aware of mental health, or you are on the brink of suicide, National Suicide Prevention Lifeline (800) 273-8255.
So for those who are hanging on, toeing the line, remembering who they are and where they have come from. What is the plan for them? What is the plan for you?
We are told to go to therapy, talk to someone, medications are prescribed with the expected side effects. A lot of the times medication is not kept in compliance because of the side effects; groggy, fussy, weight gain, erectile dysfunction (ED), etc.
“You need to go talk to someone”…
So finding a therapist is easy enough. Call the insurance company, Google search “Combat PTSD therapist, PTSD therapist, Trauma therapist” then insert your zip code – BAM you have 100s of therapists on a directory to pick from and you pick one from the picture of the description on the bio.
What are some of the questions that cross your mind when going through this process?
What is the point?
They will never understand.
It’s not going to change anything.
I’m not crazy, I don’t need to or want to talk about it.
So, let’s change the narrative.
Therapy is about building resiliency to manage and cope with the aftermath of trauma. In other words, when a person is hit with a traumatic event the person is left in pieces, resiliency is a path to get the person back together while acknowledging that they were hit. Like a vase that is dropped on the floor, you can put all the pieces back with glue, but you will always be able to see the cracks. This does not make the vase any less useful or functional. It can still hold water, it still stands; you have worth, and you have value, you did survive.
Resiliency is about discovering what you are naturally good at, what character traits do you have that you have developed. The only reason you have not been able to see them is because you have been white-knuckling through life, pushing through because you can – not because you should. Everything feels and seems so overwhelming, more likely than not because you have been doing it by yourself.
There are two basic requirements for the building of Resilience: attachment and autonomy.
Have someone in your life that you can connect with who is healthy and stable; they are there for you and you can depend on them. Have at least one relationship in which you can trust the person which is built on transparency – you want to work together to push one another and pull each other up. Resilience is a constant; you will always be working towards it, there is no endpoint, similar to fitness and workouts.
You don’t work out, eat clean, get strong, and have a phenomenal physique – and then you are done; if you stop, you gain weight, you lose muscle mass and you go back to what you looked like before. Resilience is maintaining that level of emotional strength with continual growth. The people that you choose to be around you are people you have a relationship with, helping one another while understanding the road that you have both walked and respecting the struggle.
Not everyone is up for this position; when people say, “Can’t you just get over it, it’s been so long, it’s not happening now.” Those people do not see what you have been through and cannot – so go find your tribe, your group of people who can support you even if you have not been through the same thing, someone who supports you.
Empowering yourself by showing up for your own rescue, no longer being in a victim mentality.
The victim mentality looks like: the world is always against you, that you never get a break.
Empowerment is only in the hands of the giver. The more you can give to others, the more in control you feel and you show up for yourself. You learn to give to yourself first, and then you can give and be there for others. It is all a growth and maturation process, a process of personal growth.
When you experienced the trauma, part of you got frozen in time. You stopped being able to hit milestones the way your peers did, at work, at school, with family, and in relationships. Once you are empowered and show up for yourself, you can progress through this and have the capacity to hit milestones and continue to grow.
Now you need to be primed to be in the best possible position to begin the process of building resiliency. To get there, you need to identify what is beneficial in your life now, and what is detrimental and not helpful. We all have aspects and people in our life who will take much more than what they give.
It can be the negative self-talk, with the recordings of “I can’t, I don’t want to, it’s not worth it, no one gets it.” Or the people that use you and make you feel unkind or judgmental – but they take, and they take, they are not productive, they complain all the time, and they are destructive. It can be a person who uses you to blame everything on or someone who calls you to get money or time from you, without giving back.
Once you decide to take these things out, you become much more resilient to everyday stress; you have all the resources redirected to your wellbeing. Most of the time the old habits, the old relationships, and the negative self-talk are maintained out of guilt or shame. You must decide what is taking away your energy and cut it out of your life. When you are finally able to let it go, you make opportunities to grow.
When you have self-acceptance, the capacity is underdeveloped. When there is an expression to that strength, it will be awkward – which is not an inability to grow. It is naturally going to be awkward, and as you are learning to use that skill and capacity, you want to have someone who supports your growth.
Building towards resiliency is a lifelong journey and not a destination.
Resilience is taking the experiences that you have endured and using them as proof that you can grow, honor and respect the sacrifices that have been made.
This first appeared in The Havok Journal on June 30, 2021.
Dr. Samantha Case is a Clinical Psychologist, who has been working with Combat Veterans for the past 11 years. Her private practice is CSRT Psychotherapy. Five years ago she conceptualized a different way of approaching mental and physical health for Veterans. She and her two partners have built and established a powerlifting gym, Raw Performance in Los Alamitos, CA. Within the facility she has her office, those Veterans who see her for therapy have free access to the gym floor. She launched Project Resilience in 2021, a specialized pilot program combining strength training and individual psychotherapy sessions specifically designed for combat veterans with PTSD, 100% designed by an Army Ranger Christian Lopez retired SGT Team Leader in 3/75, a Powerlifting Coach William Ha, CSCS.