What Therapists Need to Know About Supporting Clients with Military Trauma

Working with veterans and military personnel is different to working with civilians (to use the correct military jargon). Trauma is trauma, but the cultural context these clients come from is unique. If you overlook this, you risk misunderstanding this population entirely.

The military shapes how these clients see the world and themselves within it, and therefore how they’re going to behave and respond in therapy. You don’t need to be a military expert to support them, but you do need to understand their unique cultural characteristics.

Understanding the Unique Cultural Characteristics of this Group

The military is more than just a job – it’s an identity. When someone joins up, they go through a process of deconstructing and rebuilding who they are. Through this, they’re institutionalised into the culture of the armed forces.

A sense of cohesion is immediately fostered among new recruits, encouraging a deep sense of belonging to something bigger than the individual. This feeling is so powerful it usually lasts long after someone has left the armed forces.

There’s a new language to learn with different terminology and acronyms. There are specific expectations, rules, and codes of conduct. There’s a focus on discipline, and the mission is the most important thing above everything else. It’s more than just physical and occupational training. This process completely rewires a person’s understanding of who they are.

What Therapists Need to Know About Supporting Clients with Military Trauma

It’s important to understand this client group can feel as though civilians, and civilian life, are totally alien to them. They may be struggling to fit in, and this can leave them feeling vulnerable. On top of this, they may not believe a civilian will be able to understand them and their problems.

You also need to be aware that their entire journey within the armed forces will have shaped the way they think, feel and behave. As well as their general immersion in the culture of the armed forces over a prolonged period, they’ll have been impacted by things like their initial basic training and deployment. Let’s look at these in more detail:

1. The Impact of Basic Training

Basic training removes people from their family units, dismantles their sense of identity, and rebuilds them into the person the armed forces need them to be. Key attributes include discipline, the ability to follow orders, and a willingness to put the whole group ahead of themselves as an individual. Lots of people join the armed forces when they’re quite young, so this process often occurs during a pivotal point in their life as they enter into adulthood.

2. The Impact of Operational Deployment

Operational deployment usually means spending time overseas away from family in a constant state of high alert. People are often in high threat, high stakes environments where their survival, and that of their team, depends on vigilance and fast responses. This hardwires their nervous system to be constantly ‘switched on’. They also learn to compartmentalise their emotions in order to cope in these difficult environments.

This pattern can continue long after people have left the armed forces, and things like hypervigilance and the ability to numb appropriate emotional responses can suddenly become a problem.

Common Thinking Styles Within Military Culture

Certain thinking styles are very common within military culture. For example, black-and-white thinking. In the armed forces, there are rigid ideas about what is right and wrong, and this leaves little room for grey areas. There’s also a tendency towards rumination because people are encouraged to constantly evaluate performance in quite a harsh way. These thinking styles keep standards high, but they can easily turn into self-criticism or an underlying sense of inadequacy.

In general, I believe there’s a preference for order, rules and clarity within this population that can clash with the more fluid, flexible civilian approach.

Hurdles You’ll Need to Overcome

Strength and resilience are revered in military culture, so asking for help can feel like a weakness. This is why so many veterans only seek therapy many years after leaving the service. Of course, the longer people leave it, the bigger their problems can become. For example, struggling with military trauma over many years can lead people to develop unhelpful coping strategies.

As we’ve already established, military culture also rewards things like control, repressing emotions, and putting your individual wants and needs aside. In therapy, we’re essentially asking people to do the total opposite. Asking veterans and military personnel to open up, explore their feelings, feel their emotions, and put their needs first goes against the grain, so it can be a challenging, uncomfortable experience for them.

My Top Tips for Working with Veterans and Military Personnel

Avoid fluffy language. It can feel alien and unreliable to this population.
It’s important to be mindful of your assumptions about the armed forces. Even if they’re positive, they can be a barrier to building trust in a therapeutic relationship. For example, I know many veterans who cannot bear being thanked for their service or described as a hero.
Consider learning some of the basic military language your clients might use. Respectful curiosity can go a long way with this client group.
Frame coming to therapy as courageous, not weak. Remind clients that doing something difficult and uncomfortable is an act of bravery.
Be aware of the cultural conditioning military personnel experience and endeavour to understand how life in the armed forces can impact a person’s inner world and how they see themselves and other people.

About Shelley

I am a qualified, trauma informed Clinical Supervisor with experience supporting individuals, groups and trainees. I’m also an EMDR Consultant and Training Facilitator, a BABCP accredited CBT therapist and lecturer and a RN(MH). My supervision style is relaxed, supportive and focussed on providing a safe space to learn and share knowledge. Learn more about my services here and please get in touch to discuss working with me.