My wife was a medic in Afghanistan and is suffering from PTSD, including debilitating nightmares. She does not want to share her experiences with me. She needs therapy but had an unsuccessful experience with at the VA, and other therapists have long waiting lists. I’m not sure how much longer she can hold on. How can I help her?
In this video, Dr. Klassen, an expert on mental health issues and treatment, shares a list of resources for mental health therapy and discusses the challenges of moral injury.
For information about treatments for PTSD please visit The Treatment Hub.
Hi, I’m Dr. Brian Klassen and I’m a psychologist and here’s our question: “My wife is really struggling from PTSD from being a medic in Afghanistan. She has nightmares, but she won’t share anything with me. She says she doesn’t want what she sees in her head to enter anyone else’s head. And she had a very unsuccessful experience talking with a therapist at the VA near us, so we’ve been trying to get her into therapy elsewhere, but with COVID, there’s huge waiting lists. I don't know how much longer she can hold on. What should we do? “
Thank you for this question. I think it’s really, really important and I think is a great example, I think, of what a lot of couples are going through with ravages of PTSD, and also making attempts to get help that are unsuccessful. There are a couple of things I’d like to say here.
The first is that if there are long waiting list at the VA, please be aware that there are many organizations outside the VA that are also providing the same types of therapy that the VA provides. And these are organizations that are committed to increasing access, doing telehealth, and also in a sort of veteran-centric way that I think honors like a military cultural competency.
So, these are, I think, talented counselors that know what it’s like to be in a military family. And so, these are organizations like Headstrong, E-Home, Cohen Veterans Network, the Warrior Care Network, Wounded Warrior Project has several of these programs as well.
I think the second thing I’d like to say in response is that it sounds as if your wife might also be experiencing something that we call moral injury, which is this idea of participating in things or seeing things in a military context that violates one’s deeply held moral beliefs.
And this is a very difficult thing to struggle with because there’s a particular sense of guilt and shame that comes along with those experiences that can feel very isolating. And oftentimes people that have experienced moral injury, and I think many of them rightly so, kind of have this stance towards like other people, like “you won’t get it, you won’t understand. If I really share what happened or what I’ve been through, you’ll think that I’m a monster.”
And so I think the number one thing to do is really to show through your words and actions that you’re willing to listen, that there’s no judgement at all with whatever she says. Because that’s really, I think, what helps build trust if people are going to open up.
The other thing I would say is that your wife might feel more comfortable talking with clergy, might feel more comfortable talking with other veterans about her experiences. And there’s actually some good evidence to show that most people with PTSD and other kinds of mental health struggles actually don't want to talk to a clinician first. So, they’d rather talk with clergy or friends or family.
And so I think that can often be an important step in providing some relief and providing some normalcy and providing someone to listen without judgment that could eventually help a person either resolve their issues, or kind of open the door to more formal clinical treatment.
I think one final thing I’d say for this question is if you feel like you or your wife is in need of immediate help and just if she’s having thoughts of suicide, if she’s no longer sure how much longer she can hold on or wants to live anymore, there is help available by calling the National Crisis line at 1-800-273-8255 and you can push 1 if you’re a veteran.
This crisis line is available 24 X 7, 365 days a year. You’ll be connected with a licensed crisis counselor within seconds of calling who can provide intervention in the moment but can also link you with longer-term resources at the VA or in community groups. Thank you for the question.
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Brian Klassen, Ph.D., is the Associate Clinical Director for The Road Home Program: The National Center of Excellence for Veterans and Their Families at Rush University in Chicago, Illinois. Brian spent his formative years training at the Jesse Brown VA Medical Center, completing rotations in chronic pain management, residential substance use disorder treatment, and PTSD. Brian has special expertise in providing front-line treatments for PTSD, including Prolonged Exposure and Cognitive Processing Therapy.