Veterans loved their time in the service. Many, if not most, look back on their time in the military fondly, if not always accurately. This comes in many different forms. One is a type of wistful nostalgia longing for the good old days when we were young, fit, and had a full head of hair. Another is an accurate remembrance of the fact that, while there may have been some times that were really, really bad, there were also some times that were really, really good. Regardless of how we looked back on it, sometimes we wished we were still back there.
Let’s not forget, however, that we really didn’t take good care of ourselves, as best as we could, while we were in.
As both a veteran and a mental health professional, I work with veterans who have left the military and, for one reason or another, are seeking mental health counseling. In my clincial training, I learned many different evidenced based therapeutic interventions; one of these is Dialectical Behavior Therapy (DBT). DBT is a form of Cognitive Behavioral Therapy that incorporates elements of mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. DBT focuses on several aspects, but one that I use the most is teaching DBT Skills to veterans. They have found it easy to understand and apply to their daily lives.
DBT Skills come in a wide variety, but one that I teach in all of my groups follows the mnemonic, PLEASE. The PLEASE skill focuses on taking care of our minds while taking care of our bodies. The menemonic stands for:
PL: Treating PhysicaL Illness
E: Balanced Eating
A: Avoid Mood Altering Substances
S: Balance Sleep
E: Get Exercise
During a recent group, after covering these skills and turning to discussions, one of the veterans in the group said something that I hadn’t considered. “Here’s the problem,” he said in a frustrated voice. “This is how we SHOULD have been taking care of ourselves while we were in…and we did the opposite of all of it, except for the second E!”
He was absolutely right. The military that I served in might have preached this stuff, but service members…including myself…sure didn’t practice it.
Physical Illness was Avoided Instead Of Treated
I first started to notice numbness and tingling in my right hand during Jumpmaster school, sometime in 1998. It wasn’t until 2013 that I got it looked at, and was diagnosed with severe carpal tunnel syndrome. The nerve conduction study indicated that I had zero connectivity between my lower arm and my forefingers. The doc said that he had only seen that in the hands of eighty-year-olds, and another doc brought in her intern to show a classic example of uncorrected carpal tunnel that led to muscular atrophy in the heel of my hand.
In short…sick call was to be avoided, not pursued. No one wanted to be the sick call ranger. A high ankle sprain in Iraq? I went to our medic and got some crutches for a couple of days. It wasn’t until seven months after I deployed that I found out that I had microtears in the ligaments. I hurt myself on a jump in 2012, which was the beginning of the end of my military career…and still had to jump twice more just to make sure I hurt myself real good.
The DBT guidance? “Take care of your body. See a doctor when necessary. Take prescribed medication.” Maybe something we should put in place now that we’re not in the military anymore.
Eating was Not Balanced
You know the drill. MREs, the million-calorie bombs. If you are breathing while you eat, you’re eating too slow. From the very beginning, you are taught to eat quickly and cram as many calories in you as possible. Our security escort patrols typically happened in eight or ten hours segments, and when we would pull in, the first thing we would do is head to the DFAC. I would make a huge roast beef and swiss sandwich, heat it up in a microwave, and eat it as fast as I could before I fell asleep. And as great as it was at Grandma’s house at Thanksgiving, going to a Stateside dining facility was enough to put the entire squadron in a tryptophan coma. We either ate too much or not enough, surviving on RipIts and Slim Jims or cramming Pogy Bait in every available nook in our rucksack.
The DBT guidance: “Don’t eat too much or too little. Eat regularly and mindfully throughout the day. Stay away from foods that make you feel overly emotional.” Especially as the metabolism starts to slow down, the cholesterol starts to rise, and eating too much or too little has a bigger impact on us. Probably good advice for our post-military lives.
Mood Altering Substances Were Commonplace
Do I even need to talk about this one? We all know about the typical drinking culture, which my colleague Marc Scroggins talks about in this podcast. I was eighteen years old in Germany…drinking age? What’s that? I was told by someone once that there was only three things to do in Korea: go to college, go to the gym, or go to the bar. Drink, drink, drink. The use of alcohol was modeled by our buddies, our superiors, the drinking culture in the military. As a matter of fact, the Marine Corps was born in a bar…so it has that going for it. Do you think caffiene and nicotene are not mood alterning substances? Try quitting them cold turkey for a bit, and see if your mood changes. It probably spiked just thinking about it.
The DBT guidance: “Stay off illicit drugs, and use alcohol in moderation (if at all).” Mornings are a heck of a lot rougher when you’re 31..or 41 or 51…than they were when you were 21. Ramp it down, enjoy the day more.
Sleep? What was that?
We would pride ourselves on pulling all-nighters, both on duty and off. A good friend of mine once said,”there’s nothing like dawn on the drop zone surrounded by your mates.” 24 hour duty, marathon planning sessions, disrupted sleep patterns. There were times at NTC or JRTC that my 1SG had to order me to go to sleep. I was once told that my Soldiers thought I was a robot…I was always up before them and went to sleep after them, so they never actually saw me sleep. We would go and go…usually fueled by nicotine and caffeine…until we crashed. Literally; I once witnessed a crash at a stop sign in which a soldier, who had just got off 24 hour duty, fell asleep and ran into the back of the NCO he was pulling duty with. Sleep was like a unicorn…fabled to exist, but no one had actually seen it.
The DBT guidance: “Try to get 7-9 hours of sleep a night, or at least the amount of sleep that helps you feel good. Keep to a consistent sleep schedule, especially if you are having difficulty sleeping.” Of course, you say to yourself, “7 hours? Yeah, right!” After 22 years in the Army, 5AM is still a late sleep for me. If I’m lucky, 6:30. I know many other veterans who don’t even get that. Breaking the bad sleep habits we had while we were in can be critical to taking care of ourselves.
Exercise…We Liked It, We Loved It, We Wanted More Of It
My wife and I watched the Danny DeVito move Renaissance Man the other day, and there’s a scene where DeVito’s character is woken up at 5AM to the sights and sounds of early morning PT. It was always there when we were in; 5, 10, 20 mile Ruck Marches, Battalion Runs, Organizational Days. Exercise was used as a punishment…”push until I get tired, Joe”…and as a reward…”you guys get to do PT on your own today.” The Airborne Shuffle is as much as an integral part of Airborne School as is hitting the ground like a sack of crap. So, out of the PLEASE guidelines, this is the one that mostly everyone in the military actually applied.
The DBT guidance: “Do some sort of exercise every day, try to build up to 20 minutes of vigorous exercise.” Oddly enough, this is one habit that we DO break once we leave the service, and its probably the best one we should maintain.
How have you shifted your self-care habits after leaving the military? It would be great to hear your thoughts. Feel free to leave a comment below or reach out on social media.
The Head Space and Timing Blog is supported by the Colorado Veterans Health and Wellness Agency, a 501(c)3 Nonprofit in Colorado Springs, Colorado. The goal of the CVHWA is to provide military culturally competent mental health counseling to veterans and their spouses, regardless of characterization of discharge, time of service, or era of service. Our vision is to assist veterans to identify and remove barriers to their mental, physical, emotional, and behavioral wellness. For questions or inquiries, contact us!
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Does Time Heal the Psychological Impact of War? — Head Space and Timing · April 5, 2018 at 4:37 am
[…] lets the emotion cool down and the rational, reasonable side of our nature to take over. I’ve talked before about Dialectical Behavior Therapy; one of the first concepts that I teach veterans about DBT is […]
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