Veterans and Post-Traumatic Stress Disorder: A Conversation with Dr. Frank Ochberg
JS: Well, I guess that’s the point: dealing with these situations is a very inexact process, and one that relies a lot on intuition and judgment. Intuitively, I wanted to reach out and offer some kind of support. But at the same time the enormity of this guy’s pain was such that I felt I should say nothing, and just be there. And I guess veterans’ family members may be wondering how they can tell when they need to be proactive in offering support and when they need to give their loved one some space. Are there any clear guidelines here?
FO: It’s a good question. First of all, it’s not too good to say something that is superficially comforting. The “there-there” kind of statement, or, “You’ll be all right.” I think it’s good to remember this phrase I learnt as a Red Cross volunteer, which is called “the ministry of presence.” It’s just plain being there – and if you have to say something you might say, “Thanks for telling me such a hard truth. I’m listening.” Or, “Is there more?” But you don’t have to say something optimistic when it isn’t called for.
Now, what I do as a psychiatric listener is try to figure out what’s going on. And what you just described to me sounds like the person brought himself back to the trauma scene, so, as he’s talking to you he’s going back into the trauma. I wouldn’t necessarily rush him out of the trauma, and very obviously change the subject. I think I would want to be there with him to be sure he had said it all, then move on to something else, and not leave him right in the middle of his trauma story, even if I had to keep another patient waiting. That’s a decent and important thing to do.
JS: We do know, from research and personal reports, that one thing that makes dealing with trauma much more difficult is a sense of being alone or of feeling abandoned. So, I guess just having someone there, just having another human presence, can help people with the process of dealing with trauma.
FO: Yes, good point.
JS: But can we get back to the matter of advice for veterans’ partners? A veteran’s struggles can take a tremendous toll on those closest to them. What can the wives and husbands of veterans do to maintain their own psychological well-being?
FO: This is important to discuss. There’s a term that’s relevant here and that’s “care-giver burden,” where the loved one in the family becomes a care-giver and there is a certain burden. And sometimes that means that you, the family member, need to get help yourself. It could be professional help, and it could be a social worker, a psychologist, even a psychiatrist who takes you on as a patient due to your role as a family member. You also may need a rest now and then. So, everything that’s useful for the person with PTSD is useful for the person who’s caring for them. That involves taking care of your fitness, understanding your own spirituality and being sure those needs are met, keeping up your sense of humor, having a decent diet, and getting educated about PTSD-related issues.
JS: This is critical, isn’t it, because they’re giving a great deal to their partners. They’re having a lot of demands made on their physical and psychological resources, and they’re not necessarily getting a lot back because the people they’re helping are obviously struggling to deal with their own problems.