Psych 190: Warriors at Home Reactions to War

1. Psych 190: Warriors at HomeReactions to War Introductory Overview Dr. Elena Klaw

2. What’s Unique About Veterans? Willingness to put others’ lives before own Belief in mission first Loyalty as core component of service Experience of camaraderie of unit Experience of reliance on authority and hierarchy Stoicism in face of physical pain, sacrifice and uncertainty Eschew individual recognition –don’t want to be seen as heroes

3. Coming Home is Hard • Readjustment may mean changing reactions and behaviors that were key to survival in dangerous environments. • The body adapts physiologically to stress and danger and it is hard to just reset • Stress reactions on a continuum & can be acute or delayed. Feels like “going crazy.” • PTSD comes from experiencing helplessness and horror; impairment interferes with life. • Signs to get help: suicidality, problems eating, sleeping, concentrating, having relationships, or using maladaptive ways to cope that put self or others in danger.

4. PTSD • Different from combat stress reaction • Psychological and physiological changes that result from experiences of helplessness and horror • PTSD if at least a month of symptoms • Acute if symptoms less than 3 months • Chronic if symptoms more than 3 months • May experience “delayed onset” • Hoge 2004 study: 12-20% of Marines & Soldiers in initial OIF ground invasion had PTSD

5. Repeated disturbing memories, thoughts, images of a stressful military experience Repeated disturbing dreams Reexperiencing Upset when reminded of the experience Physical reactions to reminders Avoiding thoughts or activities Trouble remembering Loss of interest Feel cut off/numb Feel angry Distracted Hypervigilant PTSD Checklist (PCL-M)2 Kinds of Symptoms

6. Helplessness and Horror • Experiences involving fear of death • Witnessing death • Helplessness to end suffering • Killing • Participation in events that cause casualties, particularly involving children • Sexual assault • Repeated experiences of powerlessness

7. Other Reactions • Normal and common to experience symptoms of anxiety/depression/anger during readjustment. • Loss of camaraderie and loss of identity would be difficult for anyone to handle! • Depression, anxiety, and anger affect concentration, relationships and behavior have physical correlates. • Disorders (DSM) cause significant impairment and distress. • At SJSU: Counseling Center 924-5910

8. Negative Coping Acting out (externalizing): e.g. risky behavior, substance abuse, aggression (short fuse) Withdrawal (Internalizing): Depressive thoughts are internal, stable, and global, prevent positive coping, lead to isolation and inertia. Both increase existing feelings of shame and isolation, damage relationships.

9. Dealing with Symptoms • Has nothing to do with will or character! • Professional Counseling: U.Counseling Services (924-5910, Admin 2nd Floor), VA Hospital or local Vet Center • Can be group or individual, with or without meds • Involves having a safe space to experience thoughts and feelings so you are not flooded with them (out of your control), or experiencing physical responses, or avoiding cues • Social support is essential (e.g. class for vets, VSO, mutual help, family, religious institution)

10. Supporting Vets • Value the unique skills, strengths and vantage points of military veterans. • Share perspectives respectfully. • Increase support: VSO, Vet Centers, Mutual Help, Counseling Center. • Educate faculty, staff and peers. • Learn from peer leaders. • Increase opportunities for veterans to engage in national service and community building.