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The Individual and the Military Culture

For the civilian clinician preparing to work with veterans challenged by post-deployment stress effects, the central thing to remember is that you are preparing to work with a very different and clearly defined culture, one of which many civilians have little or no knowledge or experience.  This preparation process must be characterized by:

  • Cultural humility, the ability to appreciate the limits of one’s own knowledge
  • Cultural openness, the willingness to suspend one’s usual assumptions and ways of doing things and learn about the other culture
  • Cultural competence, words and actions based on knowledge and understanding of the other culture

One of the clinician’s most important tasks is always to find out who the individual client is, regardless of diagnoses and assessment forms.  Never is this more important than with a client who has lived through experiences so complex and foreign to civilian experience, and possibly undergone high levels of stress and trauma.  As always, the most important tools in this task are the willingness and ability to listen, and the openness that lets it all in without judging or substituting preconceived assumptions.

As van der Kolk and colleagues (1995) noted, no matter how extreme the veteran’s experiences at war might have been, it is also important to see those experiences in the larger and longer context of his or her life.  This applies both to the many positive and negative experiences that might lie outside the war experience, and to the many strengths and resources the veteran possesses.

Statements from some Service Members and veterans reveal a tendency to feel largely forgotten by the civilian population, and to believe that civilians in general do not really understand their circumstances or appreciate their service.  Given the incredible hardships many have experienced, a lack of appreciation by the public they serve may feel like a bitter disappointment, even a betrayal.  By offering to help, you will go a long way toward helping to heal some of these wounds, but the second component—understanding—is also of vital importance.

What to Call Service Members and Veterans:  Whenever we communicate with someone of another culture, we naturally have questions about language.  Learning about military terminology and values is an important step in preparing to serve this population, and one area of language—learning how to refer to service members and veterans—is an important sign of respect to the veteran.

The terms “Service Member” and “Military Member” are used in these pages because they are the most inclusive, referring to people in all branches of the U.S. Armed Services (Army, Navy, Air Force, Marines) and to both Active and Reserve (e.g., National Guard, Army Reserve) Components.  “Soldier” refers to someone in the Army (Active or Reserve), “Sailor” to someone in the Navy, and “Airman” to someone in the Air Force.  Using these terms correctly is a sign that you know a bit about the culture, and a sign of respect.

With many cultures, there is a difference between the way we refer to ourselves and the way we are comfortable having others refer to us.  The word “warrior” is a good example of a term that is used quite a bit within the military culture, and in a number of materials written about the military experience, but would be likely to fall flat if a civilian clinician introduced it in conversation.  If the veteran introduced it and you were responding, that would be a different matter.  But according to one veteran interviewee, using “warrior” as a way to show your knowledge of the terminology would not be a good idea.

And a word that is used quite a bit in the media is “hero.”  In many venues it is used almost as a synonym for “Service Member.”  Its uses may range from an expression of admiration and respect to an attempt to flatter and manipulate.  Veterans interviewed have expressed discomfort with the idea of having civilian therapists use it gratuitously, though it would make sense to use it in response if the Service Member has brought up the concept of heroism.

In “Ten Things You Should Know to Help Bring the OIF/OEF Veteran All the Way Home,” former Army Nurse Alison Lighthall provides a number of insightful suggestions for anyone who seeks to help rather than make things worse.  Among them is the following suggestion about this word:  “Returning Service Members do not think of themselves as heroes, no matter how extraordinary their skills, courage, or actions may be.  Their heroes are the ones still over there or coming home in a flag-draped boxes.”

10 Things You Should Know to Help Bring the
OIF/OEF Veterans All the Way Home

“Thank You For Your Service”:  This phrase, stated simply and clearly, is an important message for the Service Member or returning veteran.  It has no politics, and it does not probe into the details of the Service Member’s experience.  It is something the military culture recognizes as a sign of respect and gratitude for the sacrifices people are making.

Next: Avoiding Assumptions


The material on all of the Clinical Pages is taken directly from the draft version of Finding Balance After the War Zone:  Considerations in the Treatment of Post-Deployment Stress Effects, a manual under development for the Great Lakes Addiction Technology Transfer Center and Human Priorities.  This draft is copyright © 2008, Pamela Woll.  Reprint permission is universally granted, but attribution is requested.
Click here for References and Other Resources.
Click here to link to a PDF file of the current version of the clinician’s manual draft.
Click here to link to a PDF file of the accompanying booklet for veterans.

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