Ethical Education for a Better U.S. Military

The military complex must enact better proactive self-care and psychoeducation. Taking humans and asking them to live a trauma-woven lifestyle is unethical if they are not provided with the best proactive emotional intelligence and psychoeducation available. Trauma has long-term effects on the nervous system and our overall coping mechanisms. Military leaders deserve to understand how the nervous system works, so they can choose how to respond to stressors and the stressors of those under them more adeptly. Understanding how the body reacts to stressors will make military leaders better leaders. Trauma-informed training is needed for military leaders because the military culture is traumatic in nature, psychoeducation effectively reduces guilt and shame around our reactions to trauma, and preemptive care is needed to reduce burnout in the current care system.

The military complex has a multitude of in-extremis stressors. The ubiquitous stressors may include unpredictable deployments, repeatedly extended absences, unpredictable or foreign living and work environments, exposure to seriously injured and psychologically traumatized service members, occasional exposure to direct threats, and more (Johnson et al, 2019). Trauma is a full spectrum, all of which influence the nervous system. The development of unhealthy coping mechanisms can derive from unprocessed traumas, which range from a single event to withstanding long-standing stressors. There are life transitions, vicarious trauma, complex trauma, historical trauma, inter-generational trauma, collective trauma, and acute trauma, just to name a few. Military families deal with some of these in roller-coaster patterns yearly. When you cannot choose how far you will live from family or feel you are being ripped from your core family for deployment, your nervous system responds to the perceived threats. Highly traumatic events are the first criterion required to be diagnosed with certain stress disorders, including PTSD, which states, “exposure to actual or threatened death, serious injury or sexual violation” (American Psychiatric Association, 2013, p. 271). This means that the ideas and training done by the military are possibly enough to trigger traumatic stress disorders because of the perceived threat. These all lead to individual and familial dysfunctional coping without proper care.

Psychoeducation diminishes guilt and harmful long-term effects. The stress reactions in humans show up by activating their autonomic nervous systems (ANS), also known as the “Flight vs. Fight vs. Freeze response” or the “Alarm Stage” (Herzog et al., 2019). While this response helps humans survive actual or perceived threats, long-term exposure impairs the individual’s ability to control the ANS activation and responses. Understanding when the ANS activates and working with individuals to learn how to notice the tension arising and then arming them with mindfulness or grounding exercises to proactively regain control of the ANS would make a more effective, resilient military. This emotional intelligence and community language would help them tap into their intrinsic motivations for the work the military is asking of them and reduce the shame attributed to having a hard time coping. Emotional intelligence is a multi-layered asset to individual and community growth and happiness, which, unlike IQ, can be taught and learned to push people into better versions of themselves (Fossier, 2022).

“Military members, veterans, and their families will often not understand the true sources and etiology of the trauma symptoms that they are experiencing. Conducting appropriately timed psychoeducation that explains the client’s responses as a part of the ANS can greatly help these clients understand the connections between their traumatic experience(s) and these symptoms which can sometimes be quite transformative and healing… When this psychoeducation is done in a military-culturally-sensitive, human-centered, and relationship-focused manner it has been found to help these clients building resiliency as they respond to their traumatic experience(s)” (Herzog et al., 2019, p. 270). Giving the personnel and families education and community groups focused on how the nervous system responds will build self-awareness and social awareness in the community and at work. Making psychoeducation the standard will preemptively open doors to better coping techniques and keep personnel and families more mission ready. “Early intervention can increase functional capacity, rapid symptom recovery, prevention of maladaptive coping behaviors, and prevention of chronic PTSD and other psychopathology, including complicated grief. Unfortunately, while models of early intervention have been tested in non-military populations, they have rarely been implemented in military personnel” (Lieberman, 2018, p. 2). Military leaders, from E7- O10, must use proven effective tactics in military spaces and make the accepted traumatic situations they live in something the community knows how to cope with as a whole community and workplace. This will reduce suicidal ideations, provide better overall quality of life, and make the community more mission ready.

Proactive care makes sense. Our mental health providers (MHPs) and Chaplains are overwhelmed by being understaffed and overbooked with clients with suicidal ideations. MHPs are currently taking on an overbearing workload and are often at significant risk or are suffering from compassion fatigue or empathy failure. When deployed, MPHs consistently work with seriously wounded or seriously traumatized service members with perhaps little previous professional experience (Johnson et al., 2018). These syndromes come from emotional exhaustion due to excessive demands and lack of support. Empathy failure happens when a previously competent MHP attempts to process their client’s experiences while no longer being able to process the experience themselves emotionally (Johnson et al., 2018). Teaching military leaders trauma-informed psychoeducation would get to the root of these issues in a way that supports the MHPs by reducing their mental workload overall. When learning the necessary tools to connect mind and body and learning to control the nervous system more effectively, the result is less overly dysregulated service members and families feeling an emotional failure to thrive.

One valid concern is that the training will be ignored or distributed poorly. We must distribute training of this caliber with trauma-informed mindfulness or care professionals. Whether an outside source such as a Trauma Sensitive Mindfulness Teacher, or an up-to-date trained in trauma MHP, which should be a requirement at each mental health service in the military, the information will connect with personnel better if you are being taught by a person who truly grasps the concepts, knows how to teach mindfulness and cares about them being provided interpersonally and adequately. One of the more powerful techniques which should be available to instate a trauma-informed military leader is deliberate and intentional role modeling (Johnson et al., 2018). Being able to model these behaviors in education will translate into how leaders care for those in their charge. We cannot ethically put humans into overly traumatic situations and not administer the best education with the best resources available.

If administered well, trauma-informed training with basic psychoeducation will reduce guilt and shame around normal and helpful reactions to trauma. A trauma-informed military functions more efficiently and leaves less damage in its wake. It is ethically irresponsible to not do everything in our power to combat the often-fatal stress disorders that come from perceived and actual threats. The service members and their families are left to fend for themselves without this science-based and well-researched education with alarming results in the culture. The military complex is traumatic and is meant to be. That can be accepted and digested if we use basic psychoeducation on the nervous system to prepare and educate the humans signing up to do so.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental health

disorders: DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.

Fossier, K. B. (2022). Emotional Intelligence. Radiologic Technology, 93(4), 396-403.

Herzog, J. R., Whitworth, J. D., & Scott, D. L. (2019). Trauma informed care with military

populations. Journal of Human Behavior in the Social Environment, 30(3), 265-278.

https://doi.org/10.1080/10911359.2019.1679693

Johnson, B. W., & Johnson, M. (2018). Trauma-informed supervision in deployed military

settings. The Clinical Supervisor, 37(1), 102–121.

https://doi.org/10.1080/07325223.2017.1413472

Lieberman, J. A. (2018, December). Solving the mystery of military mental health: a call to

action. Psychiatric Times, 35(12), 0-5.