Post-Combat Resiliency

1. Post-Combat Resiliency Steven M. Silver, Ph.D.

2. Disclaimer The views expressed here are those of the author and do not necessarily reflect those of the Dept. of Veterans Affairs, the Dept. of Defense, or anyone with a lick of sense.

3. Steven M. Silver, Ph.D. • CPT, Pennsylvania Army National Guard • Psychologist and Program Director, PTSD Program, V.A. Medical Center, Coatesville, PA (Retired) • Marine officer, Vietnam War. • Working with war veterans since 1972 and with trauma survivors from around the world. • Researcher • Author (with S. Rogers, “Light in the heart of darkness: EMDR and the treatment of war and terrorism survivors”) • Historian

4. Core Idea • People are often incredibly resilient after combat and, where they have problems, that resiliency is what enables them to overcome the problems.

5. Presentation Goals • Describe the range and nature of reactions to combat. • Define and describe the nature of post-combat resiliency. • Find the overlooked and remaining typos in this presentation.

6. Official: PowerPoint bad for brains Professor Sweller said: "The use of the PowerPoint presentation has been a disaster. It should be ditched.” -Original URL: http://www.theregister.co.uk/2007/04/04/powerpoint_bad/

8. What are the results of combat? (Self exercise)

9. What are the results of combat? • Did you think of anything positive?

10. Key • The effects are both negative and positive. • The idea of positive effects are often hard for many to accept and that has consequences.

11. Key • What do we mean when we refer to “resiliency”?

12. Resiliency Simple definition: the ability to bounce back.

13. Combat is a classroom • All experiences teach us something. • Combat can teach resiliency (the lessons may have begun before).

14. “Mass-Cas,” Iraq

15. Key • No one remains the same after combat.

16. Key • The effects are constant across wars and eras; technology changes but people don’t. • The reactions in veterans who fought in Afghanistan and Iraq are the same as those who fought in Somalia, Beirut, Grenada, Panama, Vietnam, Korea, Normandy, Tarawa, Belleau Wood, Shiloh, and Marathon.

17. So what does the individual undergo in combat?(Sources of stress) • Physical • Emotional • Thinking/Spiritual – “Meaning” • Psychological

18. Key • Of the four, the most important is Meaning. • Why? – It is the ultimate source of difficulty AND resiliency.

19. It is not what happens that matters… …It is what it means

20. Case history “Red” and “L-T”

21. Key • In coming home, we may find we do not have the same frame of reference…

22. Consequences of combat • Are there always negative consequences? • No, but there are always changes. • And change is often viewed by others as negative.

23. Consequences (con’t) • Physical • Emotional • Meaning (Values, Spiritual) • Psychological

24. Resiliency is a tool… • To overcome the negative consequences AND • To help us grow.

25. Resiliency uses… • Strengths • Values • Purpose and meaning Shaped and learned in combat.

26. Strength example • To keep going

27. Value examples • Courage – not the absence of fear. • Loyalty • Responsibility • Team

28. Meaning examples • What really matters in life • Low “BS” tolerance

29. The struggle within • Needs all that resiliency brings

30. The struggle without Needs all that resiliency brings as well…

31. The significance of Meaning • It is the most significant need and the most significant source of resiliency.

32. Clues to a need for meaning • Unusual volunteers • “Fighting with God” • Judgments and the passing of sentences

33. The Survivors Who Made It • What did they have in common?

34. So how does healing with Meaning happen? • Permission for the search

35. Identification of the task • Meaning found through doing. • "It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life—daily and hourly. Our answer must consist, not in talk and meditation, but in right action and in right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual." -Frankl

36. A task of value • Determined how? • "We can discover this meaning in life in three different ways: (1) by doing a deed; (2) by experiencing a value; and (3) by suffering." -Frankl

37. A task of doing • Doing for others (the “others” is a personal definition).

38. A task of sacrifice • If it’s easy it doesn’t work for combat veterans.

39. And how do you know when you’ve found it?

40. No one searches alone… • The role of family, friends, society • Krause: “…Current emotional support reduces the effects of trauma on meaning, whereas negative inter-personal contacts tend to intensify the pernicious effects of trauma on meaning in life.”

41. The payoff • The resiliency of combat veterans gives us people of extraordinary ability.

42. “We honor our warriors… because they are brave and because, by seeing death on the battlefield, they come to appreciate the greatness of life.” -Winnebago Elder, 1985

43. Combat values can spread…

44. Thank you.