E-News Exclusive Locked in the Vault — Survivor Guilt in Combat VeteransBy J. Scott Janssen, MSW, LCSW Chris thought she’d heard all her father Joe’s stories about World War II. She knew everything from the fear he felt landing on the beaches of Normandy to his joy when the war finally ended and he was still in one piece. But it turns out she really hadn’t heard them all. As Joe’s kidney failure progressed, he began to recall memories he hadn’t shared. When, as his hospice social worker, I arrived one day for a visit, I could see something was on his mind. He lacked his typical friendliness and eagerness to engage. He seemed sad, possibly depressed, but said he was just feeling “off.” I asked if he could help me understand what he meant, and he said he was feeling “a kind of heaviness I can’t really explain.” I asked if he could locate the heaviness in his body. He pointed to his chest around his heart. “It’s tight right around here.” “Feel the heaviness, Joe,” I suggested. “Notice what’s going on there.” When he was focused on the feeling in his chest, I asked him to tell me the first thought or image that popped into his head. Tears started rolling down his face. “Billy Johnson,” he said. Our exchange slowed as powerful emotions churned. I asked if he was remembering a specific event; he nodded. He nodded. “Where are you?” I whispered. “Omaha Beach.” “What’s happening?” What most surprised Chris was Joe’s guilt about surviving the war when so many of his friends had not. “Sometimes I think I should have died there, too,” Joe said. “It’s not fair that I lived and they didn’t. I still feel guilty sometimes.” To enhance our sensitivity about how such guilt can haunt those who return from war, we must start with the fact that deep bonds of affection and trust often form when soldiers are joined into a single unit and thrust together into the chaotic violence of combat. Tensions can flare and nerves fray at times, but when the battle begins, they must work together and watch each other’s backs. With the stakes being life and death, with a code of behavior valuing solidarity and mutual protectiveness, it is no surprise that countless service members have spoken about the friendships formed under such adversity as being among the strongest and most enduring of their lives. When such a friend is killed, the loss can be felt as significantly and painfully as the death of a family member. The Arbitrariness of Death Taken together, the closeness of the bond, the realization that who lives and dies in battle has an aspect that is chillingly random, and the tendency to idealize those who are killed and see only the best possibilities in the lives that were suddenly lost is a mix that breeds guilt in survivors. Such guilt may be intensified by the complicated grief and posttraumatic stress that often plagues combat survivors. Some even walk away feeling personal responsibility for deaths specifically or in general. When I asked Joe what it would mean to him if he woke up one day and the guilt he felt at surviving the war was gone, he said it would mean betraying the memory of his fallen friends. Before we could find ways to lessen the pain, we first had to explore ways he could honor these friends that no longer required guilt as a sign of his fidelity. Don’t be in a hurry. Sometimes when we sense another’s pain, we may feel an impulse to rush in and try to comfort or probe for insight. Traumatic memories can be very intense and vivid. Before inviting exploration, establish a sense of safety and trust where there are no judgments and no pressure. Let the veteran control the pace and tempo of such explorations. It is not social workers’ job to force someone to go where he or she does not want to go, though we may communicate that we care and that it is safe to do so if the person so chooses. Be ready to listen compassionately to the stories without flinching, even when they are painful to hear. One way to work with the mind’s tendency to keep the past alive by replaying painful stories, images, and memories (and, in the case of trauma, the nervous system’s tendency to replay intense somatic upset) is for these stories to be released from the deep inner vaults where they are often stored, to share them in a context that is loving, respectful, and affirmative. Though we may not be platoon brothers and cannot fully understand what it means to survive combat, as social workers, we may find ourselves standing beside someone like Joe. When we do, it is not our job to try to force the vault open. But if we remember the healing power of attuning to another’s inner experience in ways that communicate that it’s safe, that we care, that we are prepared to listen without judgment, to bear witness, we will be ready if the vault cracks ever so slightly ajar. — J. Scott Janssen, MSW, LCSW, has been a hospice social worker for 20 years and currently works for Duke Hospice in Durham, NC. He authored the book The Dawn Is Never Far Away: Stories of Loss, Resilience, and the Human Journey. |