Honoring Our Veterans’ Grief Journeys
Author:
Kaylee Kron, LMSW
Challenges faced by service members
By now, we are relatively familiar with many of the challenges faced by our service members throughout their enlistment. Many live with diagnoses like post-traumatic stress disorder (PTSD), mood and anxiety disorders, along with other conditions such as sleep problems, substance use, and relationship issues [1]. In a very real sense, the lives of military veterans are forever impacted by their time in the military.
From the moment of enlistment to the time of discharge, and for the rest of their lives, service members experience loss at disproportionate rates, from the largest losses, including the death of a brother or sister in arms or the loss of limbs and mobility, to the seemingly smaller losses, such as loss of autonomy, loss of time with family while deployed, and loss of perceived purpose upon returning home. For veterans, losses both large and smaller by comparison are losses nonetheless and merit the space needed to truly grieve what has been taken from them.
Mental health in veterans
According to the U.S. Department of Veteran Affairs, less than 50% of military veterans receive mental health care [1]. While a large percentage of veterans do not receive mental health support, the data also shows that services members are disproportionately impacted by PTSD, depression and suicidality [1]. This may be due to several causes, including the stigma associated with seeking mental health support faced by service members.
The psychological toll active duty takes on an individual cannot be argued. In fact, we have the deep trauma faced by military personnel who served in the Vietnam War to thank for the establishment of today’s very well-known diagnosis of PTSD. A diagnosis of PTSD within the general population is prevalent, affecting 3.6% of men and 9.7% of women, yet veterans of the Vietnam War experienced such concentrated trauma that this diagnosis originally was characterized as “experiencing combat” [2]. It is worth noting, however, that since its inception, the diagnostic criterion for what categorizes a traumatic experience has shifted from concrete experiences to the perception of experiences as traumatic to the individual who experienced them [2].
Addressing grief experienced by veterans before, during and after deployment
As we consider the impact of service on military personnel, we must also address the many and repeated losses they experience as a result of that service. For our purposes, we will look at grief through the lens of losses through death as well as non-death losses faced by individuals while in service to our country as well as losses following discharge.
Death losses
Due to the nature of military service, veterans bear witness to death on a more frequent basis than the average individual. This relates both to death in combat as well as death by suicide, as veterans’ suicide rates are roughly 32 per 100,000, whereas the general population shows rates of 17 per 100,000 [3]. While death in active duty has significantly decreased over the past few decades, the rate of service members dying by suicide has continued to increase, making the suicide rate of military personnel higher than the suicide rate of those in active combat as we well as higher than the suicide rate of the general population [4]. With this in mind, it is likely that many veterans have been personally impacted by the death of a brother or sister in arms’ suicide while in active duty, after discharge or both.
Because the deaths experienced by individuals in the military are traumatic in nature, death grief in veterans may overlap with PTSD [4]. However, there is little to no data on the grief impact of suicide losses on military veterans versus grief experienced through loss in combat. Due to this gap in understanding, there is much to be desired regarding mental health and physical health treatment in veterans at this time [4].
Barriers to care
In addition to the stigma associated with veterans seeking and receiving mental health care is the sheer number of military personnel, both active and inactive, who need support. Truly, as with mental health care for other demographic groups, the need for care outnumbers the capacity of those who can provide the care that is needed [5]. According to Lifeline for Vets, in 2005, 22% of veterans seeking mental health support sought treatment in the private sector due to long wait times experienced at the VA [5].
Non-death losses
Much attention must be paid to the genuine and deep grief experienced through death, but it is also important to consider the additional losses that veterans experience throughout their service. As we explore just a few potential losses, reflect on your experience or the experience of a loved one who has served in the military.
Bootcamp and deployment
When an individual leaves for bootcamp and deployment, they are often leaving behind family and friends, holidays and celebrations, life milestones and times of connection. While many service members may feel a deep purpose in their time spent away, there is also loss of each milestone for which they were not present. Grief in this regard can be felt while away from home, but it can also be felt upon returning when life has continued to move and evolve without their presence. This feeling of loss can result in veterans feeling removed from family and friends, leading to isolation, depression and substance use [4].
Discharge
Oftentimes, when we think about discharge from the military, we picture heartwarming and tear-provoking images of soldiers coming home to meet their child for the first time. While there is absolutely space for celebration in reunion and returning to “normal” civilian life, there is still loss.
Upon discharge from military service, there is an enormous shift in an individual’s daily life. While they may gain autonomy over themselves and their choices, they lose a familiar (and sometimes comforting) sense of knowing what to expect and what is expected of them with each passing day. They are left with the requirement to self-direct. After however many years of service, this can be a difficult change, and some veterans grieve the loss of predictability.
Supporting grief by giving a voice to it
Something incredibly important to consider through this lens is that grief can occur inside happy moments as well as difficult ones. With every life change, there are aspects about oneself and one’s reality that are gained as well as lost – and that is okay. We do not dishonor our happiness by grieving what has been lost, nor do we disrespect our pain when we find gains inside a deep loss. As we navigate complicated feelings, we have the opportunity to be kind to ourselves; however, more often than not we punish ourselves for not being “thankful enough” or because “other people have it worse.” This belief structure further isolates the individual and only serves to shove the grief further down; it’s still there, but a little stifled.
If you are someone who has served in the military and this blog resonates with you, I encourage you to begin honoring your own grief experience. Think about the moments of change you have experienced and pay attention to both the happiness you felt and the feelings of loss.
As someone who deeply loves an individual who has served in the military, I know firsthand how daunting it can feel to provide the “right support” or ask the “right questions.” In knowing just a fragment of what my loved one has been through, I wonder how I could possibly provide any comfort for their pain. I often fall back on my training as a grief counselor – in knowing that it is not my job to make their pain go away, because that is simply not possible. Rather, my job, both as a grief counselor and as a loving person of someone who is suffering, is to help them feel just a little less lonely than they did before our time together. Here are a few tips to facilitate this process.
- Stay compassionately curious. Many people do not realize that it is okay to ask questions, if the reason you are asking is based in compassion and a desire to understand the other person’s experiences.
- Sit inside the discomfort. While having a conversation with an individual who is experiencing deep grief, whether in relation to their military experience or not, you may hear discomfiting stories or statements. Your instinct is to try to “make it better” by pointing out how it could have been worse, or by reminding them how lucky they are, or how strong they are, or how loved they are, and so forth. Do not do that. Instead allow then to feel however they need to feel without acting on your desire to fix it.
- Create a safe space for difficult emotions. The very best way to support your loved one is to create a space where hard emotions can be expressed – free of judgment or discomfort. Following the first two steps can get you to a place where your loved one feels safe to express their emotions. If or when this happens, STAY.
Military resources
- National Alliance on Mental Illness (NAMI): Veterans & Active Duty
- Multiple resources and education
- Support groups
- https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/Real-Warriors-Campaign
- Offers resources and education
- 24/7 live chat to talk with a trained psychological health resource consultant. Conversations are free and confidential
- Military One Source: Mental health resources
- Offers multiple resources for different mental health issues, e.g., military crisis line, sexual assault, PTSD, abuse, substance use disorders, etc.
- Mental Health Resource for Veterans
- Specific resources for veterans and their families
- Vehicles for Veterans
- Multiple resources including free clinics/outreach, free online communities/peer support, referral programs, etc.
- Mental Health Department at the VA
- Resources and search engines to find the support you need
- Moving Forward Program: https://www.veterantraining.va.gov/movingforward/
- Course to help with navigating challenges in life
- MentalHealth.gov: Help for service members and their families
- List of resources for service members and their families
- SAMHSA National Hotline: 1-800-662-4357
- https://www.samhsa.gov/find-help/national-helpline
- SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders
Sources
- Spotlight on Mental Health (va.gov)
- PTSD History and Overview - PTSD: National Center for PTSD (va.gov)
- Suicide Among Veterans: Veterans' Issues in Focus | RAND
- Grief in Veterans: An Unexplored Consequence of War - PMC (nih.gov)
- Veteran Mental Health - Facts and Stats That Need to Be Addressed (nvf.org)
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