Part two: Stress in the Military

Crystal Shelton, CVN’s Vice President for Clinical Programs, previously served as an active duty social work officer in the United States Navy. During her time in uniform, she worked with infantry marines and combat instructors at the Marine Corps School of Infantry offering evidence-based interventions in the clinic and out in the training field.

In a two-part series, Shelton puts her experience to work while examining what stress is like for those in service. Part one ran last week

Crystal Shelton

Crystal Shelton

There is no simple way of predicting what will be the thing that unravels an individual who was otherwise able to hold up well under stress. As I noted in part one, there isn’t always a direct correlation between a mental health diagnosis and poor stress response. I’ve met a non-inconsequential number of senior enlisted and officers who have hallmark traits of Bipolar II, their chests full of ribbons denoting meritorious service. It is as if their ability to work longer hours, obsess over details, their seemingly endless reserve of waking hours and episodes of grandiosity are precisely what has aided them in their notable career progressions. It only becomes an issue when what was once irritability becomes aggression and what was once feeling a little down becomes can’t get out of bed. Conversely, even someone with a fairly hearty psyche who has shown few outward signs of distress can be surprised to find that going to the grocery store or taking out the trash suddenly causes a panic attack. This can start long before deployment.

Resilience is a poorly defined and measured concept, but if I had to take a stab at it I would have to say it is rooted in our self-talk. The people who are more vulnerable to anxious distress can say some incredibly bad things to themselves when faced with a difficult task. They can tell themselves they suck, they will tell themselves that they are responsible for every horrible thing that may have happened on a deployment, they can call themselves a failure, they can even tell themselves that everyone knows they are a failure (because even when we believe we are terrible at everything else, we always believe we are world-class mind readers). People who are more insulated from anxiety and anxious distress tend to take a different approach to self-talk. This includes my young psychotic Marine. When faced with something difficult, the approach is more like: one foot at a time; one foot at a time; one foot at a time.

At CVN, I want us to commit to embracing the complexity of our clients and their military experiences; I want us to ground our care in the underlying assumption that our client’s experiences are unique and that, no matter what we learn about deployment cycles and stress in the military, there is always something more to learn. We are in an incredible position to gather data on stressors, resilience, and change over time.

 

By Crystal Shelton
CVN Vice President, Clinical Programs