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Trauma is messy. It can come loudly, in the form of a terrible accident or threat. It can come suddenly when an unexpected change changes our sense of our world, our future and ourselves. But when you are a veteran, trauma is, unfortunately, a part of the job description.
As a soldier, you’re faced with long deployments away from home and family. Such separations take a toll on relationships and can significantly harm your physical and mental health.
And then there is the significant risk of harm that soldiers face as an attribute of their service. You’ve likely experienced the loss of brothers and sisters in arms. Your own life has likely been under threat more than once. These are traumas that don’t heal easily or quickly.
Sometimes drugs and alcohol can feel like the only remedy for the grief, anxiety and sadness you may feel in the aftermath of trauma. But what once might have helped you cope can quickly become a source of pain, grief and trauma in its own right.
Addiction among veterans is a persistent problem but it doesn’t have to be this way. Addressing substance misuse at its root can help America’s heroes build the health and happy future they deserve. The key is trauma-informed care.
Understanding Trauma in Veterans
For many veterans, trauma is a form of unresolved grief. You’ve likely said goodbye to more than one friend or loved one, lost in the bloom of life. You may have lost a relationship, such as the ending of a marriage, due to the incredible stressors of a life of service. And if you’ve experienced combat, you likely no longer move in the world with the sense of safety and security you once enjoyed as a civilian. You have simply seen too much and perhaps, above all, you’re feeling grief for the innocent worldview you once knew.
We often hear about grief as a process that comes in stages but it isn’t that cut and dry. Rather than being a linear process, grief bends and loops and it’s all over the place. Anger might show up before sadness and then it might return again later. Acceptance can last for a week or a month, then vanish.
Then the shock you already experienced is back again. This convoluted experience doesn’t mean you’re grieving incorrectly. It simply means you’re a human being who is hurting. Perhaps you loved a loved one whether that be through death or a conclusion of the relationship. Maybe a dream you’ve had for your entire life has now collapsed in front of your face. Now you’re crushed. You’re overwhelmed, disoriented and profoundly isolated.
Grief is an extremely painful experience for a lot of us. The temptation to seek solace in drugs or alcohol can become strong. We think, “A drink might take the edge off, or maybe some medication might dull this feeling for me.”
At the moment it can feel like a glass of water in the desert. The truth of the matter is that turning to drugs or alcohol rarely solves the problem. What began as a coping mechanism has now evolved into temporary dependency. Then that temporary dependency becomes stronger and it compounds into even bigger challenges than how our grief started.
The Benefits of Trauma-Informed Therapy For Veterans
Trauma-informed therapy can be especially effective for veterans because it provides a way to experience grief in a setting that’s safe. It’s a place where we can process emotions authentically, and cope without substances. Therapy isn’t a crutch though. It is not about avoiding grief or ignoring it. Therapy is about learning to live with the loss, finding positivity in life and gradually developing purpose and stability. It’s how we finally say, “I’m taking my life back.”
Your therapist should help you deal with both your trauma and your substance misuse, whether this is the potential for substance misuse or misuse already occurring. By sitting with a compassionate mental health professional and exploring the emotional roots of the substance misuse and identifying triggers, we can then learn strategies that allow us to cope in healthier ways without turning to alcohol or drugs.
The goal of therapy is to be able to talk without the fear of being judged. An experienced counselor will not be judgmental and they will guide us through all of the parts of grief. They can help us understand our pain and deal with that pain in functional ways. There are different therapeutic approaches that can work for different people. These different approaches are evidence based to assist with grief and prevent or mitigate substance misuse.
Cognitive Behavioral Therapy (CBT): CBT is a great option because it focuses on helping you understand the connection between our emotions and behaviors. For example, someone who’s grieving the loss of a friend in combat may feel guilty for returning home to their family. They may judge themselves when they experience happiness or joy. Or they may blame themselves for the loss that occurred.
CBT can help to identify these faulty thought patterns and teach you how to reframe these thoughts in ways that are realistic, healthy, and balanced. CBT can also offer useful tools for recognizing triggers that can lead to substance use, and then assist in developing alternative behaviors such as meditation, physical exercise, or another hobby.
Mindfulness Therapy: Mindfulness is often very effective for veterans who are dealing with anxiety. It teaches you to be present in the moment when memories of past traumas feel inescapable. If you find yourself in an anxiety-producing situation, one that perhaps reminds you of a dangerous situation you encountered during your service, then using mindfulness can help bring you back to the present and to the safety and security of the current moment.
Things like grounding exercises, deep breathing and meditation can help you to stand back and observe these feelings but not be consumed by them. You can actually learn to tolerate the emotional discomfort until it passes rather than turning to drugs or alcohol to avoid it.
Peer Support: When you’re feeling sad, angry, or anxious, it can help to know you’re not alone. You can sit and talk with others who are in similar situations and even cry together. It’s helpful when you learn and with others and lessen those feelings of loneliness. Grief is normal and recovery without drugs and alcohol is very possible.
This is strengthened by peer validation and that’s why programs that are designed specifically for veterans are especially helpful in resolving trauma and addressing substance use disorders among active duty and former military personnel.
Many veteran-focused addiction recovery programs offer extended care services, such as sober living programs, to help residents cultivate their sobriety with the support of fellow veterans in recovery. This can be an invaluable asset when you’re seeking to reintegrate into civilian life, heal from the traumas of the past and move forward into the future you and your loved ones deserve.
Eye Movement Desensitization and Reprocessing (EMDR): EMDR helps process traumatic experiences that keep you stuck in a grief and fear loop. EMDR uses guided eye movements and other forms of bilateral stimulation to help the brain reprocess trauma in a way that doesn’t take the trauma away, but it makes it less paralyzing. EMDR can also help to ease feelings of guilt and anger that sometimes are tied to trauma and loss, allowing us a setting for healing and acceptance.
Healthy Coping Strategies for Veterans
A lot of people think that professional therapy is only about talking. While therapy does involve talking, it is more than that. Therapy can equip you with concrete tools to help us manage grief in ways that are not just functional, but healthy. Some examples of useful coping strategies include:
Social Support: Leaning on friends and family can offer a significant amount of emotional safety. Just knowing there are people who love us is important. Being able to share feelings candidly with these people can be incredibly validating.
Professional Support: Having a doctor and a therapist is a great start. There are also crisis lines with trained professionals who are able to provide empathy during critical moments. Case managers and social workers can point us to valuable resources to ensure practical needs are met. Your local veterans office may be able to help also.
Physical Exercise: Movement releases endorphins which improves mood and helps regulate stress. Some examples of physical exercise are walking, doing yoga or even dancing alone in the living room.
Activities of Daily Living: Attending to a routine of healthy eating, sleeping, and practicing good hygiene helps keep emotions regulated during turbulent times. This can also work to prevent stress.
Focus on Others: Contributing to the community can really foster a sense of purpose. When we have connection with others and are tasked with providing care to others, this not only works to reduce isolation, but can also provide deep emotional fulfillment.
Taking Steps Forward
Making the decision to get help can feel scary. Sometimes it’s hard to commit to the recovery journey and it can take more than a session or two to find the therapist and the treatment path that’s right for you. The process can feel intimidating, especially when you’re not your best self due to the pain you’re experiencing. Breaking the task down into simple steps can help it feel less daunting:
Finding a Therapist:
Consult with the VA: Veterans can receive high quality mental health and addiction recovery services at any VA medical center and at outpatient clinics offering mental health care. These programs can be your best bet in connecting with a qualified therapist specializing in addressing the unique needs of active duty military personnel, veterans and families.
Consult with your insurance. If you prefer not to go through the VA to find care, you still have a lot of options. Many insurance providers will offer you a list of covered therapists in your area that your plan accepts. If you have a job, see if there is an EAP benefit. EAP often provides a limited amount of free therapy sessions.
Use crisis lines. Many people call 24/7 crisis lines while seeking a therapist or in between appointments to help get them through critical times. Even if you’re not currently in crisis, they can often still help you by providing you with supportive listening and offering additional resources.
Start a list. Keep track of who you are contacting when you pursue finding a therapist. This can help you remember who’s not taking new clients. If a therapist has a waitlist, this is important information to notate on your list. You can also take note of where they are located and how quickly you can be seen.
Questions to Ask:
You should find a therapist that works for your needs. They should be someone you’re comfortable sharing sensitive information with. If you click with your first therapist, that’s okay. Sometimes it takes a little while to find the right one. Some questions to consider:
Do I prefer telehealth or would I rather be seen in an office?
Do I feel comfortable being completely honest with this therapist about all of my feelings, habits, and goals?
Does the therapist have experience with both grief and substance misuse?
How do I feel after being seen by the therapist? Do I feel frustrated? Do I feel lighter and more hopeful?
Be Encouraged
Trauma is not neat. It’s not pretty. And healing takes time. It is possible to manage without being completely overcome by it if you have the right support. Therapy can offer you a way to accept your pain, honor it, and go on in life without turning to substances. You can do this.
