Battling loss and grief are normal after suffering a difficult life event. Whether you have a veteran patient who has lost a loved one to illness or an accident, had his or her sense of safety and security stolen from them after being nearly killed in combat, involuntarily separated from service, or were left feeling vulnerable, worthless, and lonely after a breakup or divorce, it will take time for them to heal.
Feeling depressed and anxious, having problems with sleep and appetite, and feeling angry, resentful, and numb are to be expected in our veteran patients who experience significant loss. It doesn’t mean they are crazy.
And it is important for us as clinicians to constantly remind them of this fact. Fortunately, for the vast majority of veterans, these problems are time-limited. They will “bounce back” in most cases, but education about grief can hasten their return to baseline.
As a clinician, it is important to remind your client that healing takes time. In spite of what the old saying claims, time does not necessarily heal all wounds … but it usually does help. Education your patient about the importance of not rushing through the grieving process. Help them accept the fact that their life has changed while also remembering that growth can come with change.
Encourage your patient to rely on those who care about them and whom they trust. Few things in life are done well in isolation. This is particularly true for overcoming emotional struggle. The collective compassion and wisdom of your client’s immediate social support system can be immense, but they must first ask for it and accept help when it is provided.
Mourning the Loss
Make sure you veteran client understands that he or she needs to mourn. Grief can produce a profound sense of emptiness and despair. To overcome these feelings, a person needs to mourn the loss. In contemporary American culture, this practice is often overlooked. We tend to encourage people to “suck it up,” “move on,” and “think about other things” as strategies for overcoming loss.
This attitude is particularly true in American military culture. Unfortunately, these techniques generally are seen as uncompassionate and nothing more than platitudes.
Encourage your client to actively mourn the death of a loved one through a wake, a funeral, or a memorial service. These formal activities allow your client to remember his or her loved one and start the process of letting go. The activity does not have to be large, grand, or even shared with other people. All that is needed is the opportunity to say goodbye in a ritualistic form, a process that is helpful for many different people. This is particularly true for those with more religious and spiritual connections.
For someone who has recently divorced, an act of mourning could be donating to charity anything that an ex chose to leave behind. Or it could consist of burying, burning, or giving away pictures and other visual reminders of the relationship.
A person who narrowly escaped death from combat or suffered sexual assault may hold a “funeral” mourning the loss of his or her previous sense of safety and security while also celebrating the promise for creating a more realistic, yet optimistic view of life.
Empty Chair Technique
An activity I’ve found helpful when working with people who are struggling in the aftermath of trauma is to ask them to become the professional. The ability to look outward and to focus on providing support, guidance, and advice to others is a great way to temporarily separate yourself from your distress.
In essence, you are asking your client to become the therapist and role play how he or she would like to be comforted and supported. The use of the “empty chair” technique may be beneficial.
Losing something or someone important to us is a harsh reality that we all must face at some point. And like any service member (or civilian) knows, being prepared is the key to moving through the smoke swiftly and safely.
Our job as clinicians is to help them navigate the process more fully, openly, and efficiently.
*A previous version of this article was published in Dr. Moore’s column Kevlar for the Mind, which is published in Military Times.