1. Psych 190: Warriors at Home Reactions to War Introductory Overview Dr. Elena Klaw

2. What’s Unique About Veterans?  Willingness to put others’ lives before own  Belief in mission first  Loyalty as core component of service  Experience of camaraderie of unit  Experience of reliance on authority and hierarchy  Stoicism in face of physical pain, sacrifice and uncertainty  Eschew individual recognition –don’t want to be seen as heroes

3. Coming Home is Hard  Readjustment may mean changing reactions and behaviors that were key to survival in dangerous environments.  The body adapts physiologically to stress and danger and it is hard to just reset  Stress reactions on a continuum & can be acute or delayed. Feels like “ going crazy. ”  PTSD comes from experiencing helplessness and horror; impairment interferes with life.  Signs to get help: suicidality, problems eating, sleeping, concentrating, having relationships, or using maladaptive ways to cope that put self or others in danger.

4. PTSD  Different from combat stress reaction  Psychological and physiological changes that result from experiences of helplessness and horror  PTSD if at least a month of symptoms  Acute if symptoms less than 3 months  Chronic if symptoms more than 3 months  May experience “ delayed onset ”  Hoge 2004 study: 12-20% of Marines & Soldiers in initial OIF ground invasion had PTSD

5. PTSD Checklist (PCL-M) 2 Kinds of Symptoms  Repeated disturbing memories, thoughts, images of a stressful military experience  Repeated disturbing dreams  Reexperiencing  Upset when reminded of the experience  Physical reactions to reminders  Avoiding thoughts or activities  Trouble remembering  Loss of interest  Feel cut off/numb  Feel angry  Distracted  Hypervigilant

6. Helplessness and Horror  Experiences involving fear of death  Witnessing death  Helplessness to end suffering  Killing  Participation in events that cause casualties, particularly involving children  Sexual assault  Repeated experiences of powerlessness

7. Other Reactions  Normal and common to experience symptoms of anxiety/depression/anger during readjustment.  Loss of camaraderie and loss of identity would be difficult for anyone to handle!  Depression, anxiety, and anger affect concentration, relationships and behavior have physical correlates.  Disorders (DSM) cause significant impairment and distress.  At SJSU: Counseling Center 924-5910

8. Negative Coping  Acting out (externalizing): e.g. risky behavior, substance abuse, aggression (short fuse)  Withdrawal (Internalizing): Depressive thoughts are internal, stable, and global, prevent positive coping, lead to isolation and inertia.  Both increase existing feelings of shame and isolation, damage relationships.

9. Dealing with Symptoms  Has nothing to do with will or character!  Professional Counseling: U.Counseling Services (924-5910, Admin 2 nd Floor), VA Hospital or local Vet Center  Can be group or individual, with or without meds  Involves having a safe space to experience thoughts and feelings so you are not flooded with them (out of your control), or experiencing physical responses, or avoiding cues  Social support is essential (e.g. class for vets, VSO, mutual help, family, religious institution)

10. Supporting Vets  Value the unique skills, strengths and vantage points of military veterans.  Share perspectives respectfully.  Increase support: VSO, Vet Centers, Mutual Help, Counseling Center.  Educate faculty, staff and peers.  Learn from peer leaders.  Increase opportunities for veterans to engage in national service and community building.