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A SHATTERED TRADITION

A SHATTERED TRADITION. Vignette Learning Points. Issues Raised in Vignette. Captain Jessica Andrews is a West Point graduate in charge of a platoon searching caves for weapons in Afghanistan. During a cave search, one of her men

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A SHATTERED TRADITION

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  1. A SHATTERED TRADITION Vignette Learning Points

  2. Issues Raised in Vignette Captain Jessica Andrews is a West Point graduate in charge of a platoon searching caves for weapons in Afghanistan. During a cave search, one of her men trips a wire causing an explosion which kills her men. She survives, but sustains serious injuries. CPT Andrews undergoes life threatening surgery and awakens to find that she has facial nerve damage and that her reproductive organs were removed. She experiences survivor guilt.

  3. Upon her return home, CPT Andrews learns that her parents were mistakenly informed that she was killed in action. • In their grief, they were killed while driving when they lost control of their vehicle. • She mourns the tragic loss of her parents with whom she maintained a close bond, as they both graduated from West Point. • CPT Andrews has lost the ability to smile or show emotion due to facial nerve damage. • Confronted by the county to take away her ranch and build a highway, she responds by kicking off the surveyor from her ranch and vows to fight the county.

  4. • Jessica refuses the help of a county social worker, a Veteran, who pays her a home visit. • She feels deep sadness and despair, self-hatred, depression and suicidal thoughts. • In the evenings, she displays PTSD symptoms of hyper-vigilance. • Jessica seeks therapy with a psychiatrist for the treatment of depression and suicidal ideations. • She copes with her altered body image by horseback riding, running and yoga.

  5. • Jessica begins to give horseback riding lessons on her ranch to two young girls. • She develops a mutually rewarding relationship with the two young girls and their mother. • Jessica regains a positive affect and begins to develop a hopeful perspective about herself and her future.

  6. Issues Addressed in Therapy • CPT Jessica Andrews experiences multiple devastating losses, including her parents, men in her platoon, a permanently altered self-image, her reproductive ability and her military career. • She talks about her feelings of anger and self-hatred, sadness and depression, as well as survivor guilt. • The therapist monitors her suicidal ideations.

  7. Issues Addressed in Therapy • She no longer is able to show on her face what she is feeling. • Jessica learns to cope with her altered body image by horseback riding, yoga and running. • She discovers a sense of personal competency when she regains a limited ability to express her emotions. • Jessica regains her self-worth and a sense of belongingness through the supportive relationship she develops with two students and their mother.

  8. Questions • What worked? • What didn’t? • What would have done differently?

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