In his course on book writing, Bill O’Hanlon first has his students go through a series of exercises to help focus the process. I have combined the first exercises into the following paragraphs:
Even therapists experienced in standard trauma-focused therapies can find themselves feeling inadequate when working with post-9/11 combat veterans. It is easy enough for therapists to learn how to differentiate between a soldier and a Marine (and why one would be well-advised never to confuse the two!). Often, though, they still end up wondering, “Why do some veterans avoid engaging fully in treatment in the first place, even after they have overcome, at least initially, the stigma of seeking mental health care?” or “What do I do about those combat veterans who do not easily move back into post-combat life, even after fairly successful ‘standard’ treatments?”
In this book, I offer therapists a way to answer those questions by suggesting seven narratives that they can use to make better sense of veterans’ lives both during and after combat. In any good story, actions and states of being imply consequences, so with these seven narratives in mind, therapists will be able translate veterans’ experiences into more “therapeutic war stories” so that the veterans may not only find more peace with what they felt, saw, and did while “down range” (as they call it), but also then consider better possibilities for their growth into more meaning-filled lives as civilians.
I write the book for mental health professionals who work with or who wish to work with post-9/11 combat veterans, yet who are not yet familiar with ways to conceptualize the stories that combat veterans may tell about themselves, stories that can sometimes limit the efficacy of treatments, whether evidence-based or not. While previous books have focused on what to do about the sufferings of post-9/11 veterans with combat trauma, I focus instead on how to conceptualize better the stories implicit in those sufferings so that the veterans might then be able to benefit even more from evidence-based treatments.
The book is structured as a series of reflections on seven veterans whom I “encounter” on a particular “work day,” sandwiched between two stories I “think” about as I “drive” to and from work on “that day.” It is what I imagine might arise if the Diagnostic and Statistical Manual (DSM) were to meet The Canterbury Tales.
Next, he has us consider a possible “back cover” of the book, with a summary and a bio. So he goes:
A young combat veteran enters a mental health clinician’s office and sinks into the chair next to the desk, as carefully as he once must have done when he had taken aim, as a sniper, at a target then mere yards away, now a world away from that consulting room, an eternity before that moment, and after a cautious glance left, then right, he fixates his eyes on his new counselor and whispers, “I don’t want to be here. I don’t want to be anywhere.”
In this book, Dr. Rodney Deaton, a psychiatrist and psychotherapist who has worked extensively with combat veterans from the conflicts in Iraq and Afghanistan, calls on doctors and therapists who have encountered such veterans in their practices first to ask themselves not “What should I do?”, but rather “What’s the story here?” He urges them to focus not just on the veterans’ symptoms, as important as those are, but also on the veterans themselves, on the persons the veterans have encountered on their journeys back home, on the paths they may or may not have taken, and on the stories they might be living out, stories such as:
–The Voyage and Return
–The Modern Tragedy
–Overcoming the Monster
–The Ancient Tragedy
–The Quest Beyond
By considering seven veterans who embody the conflicts and the narrative arcs of these stories, Deaton, in a manner more reminiscent of The Canterbury Tales than of the DSM, offers guidance for clinicians who have wondered “Why do some veterans avoid engaging fully in treatment in the first place, even after they have overcome, at least initially, the stigma of seeking mental health care?” or “What should I do about combat veterans who do not easily move back into post-combat life, even after fairly successful ‘standard’ treatments?”
In the end, he argues, when both veterans and treaters embrace the parts each must play in the stories of hope-filled recovery that they are trying together to tell, both will learn more deeply not only what it means for one to accept what cannot be changed, but even more what it promises for one to live each day for what can be.
Rodney Deaton, MD, JD, is the Medical Director of the Warrior Wellness Unit at TriStar Skyline Madison Campus in Nashville, Tennesse and Assistant Professor of Clinical Psychiatry at Vanderbilt University School of Medicine. A graduate of Indiana University School of Medicine and Harvard Law School and the recipient of teaching awards from Indiana University and the American Psychiatric Association, his essay blog, Paving the Road Back: Serving Those Who Have Served in Combat, was named one of WordPress.com’s Editors’ Picks Blogs of 2013.
Finally, he has us come up with a tentative title, so here goes, Part II:
Therapeutic War Stories: Seven Narratives for Therapists to Guide Post-9/11 Combat Veterans Toward More Meaning-Filled Lives
So there you have it folks, the work up ’til now. Any thoughts, responses, guffaws, quizzical “what the . . .”‘s, etc., will be welcomed. Really.