Report for RAR National Conference Randwick NSW, 2010.
After two treks and having processed the information, seen the outcomes and spoken with the younger veterans, our belief in the value of this approach to military induced stress illness has been reinforced. The value of veterans helping veterans from a different generation works extremely well. As mentioned in the reports and in many societies this approach is adopted and is the basis on which information and advice is passed from one generation to the next. The theory which explains this phenomenon in sociometric terms is cognitive behaviour therapy, generally referred to as CBT. This is the theory of behaviour modification or change resulting from counselling, a word from which I tend to resile. Nonetheless, it is the process which causes individuals to recognise problem behaviour and change habits for a better outcome, (insert family and community life).
In civilian and also DVA terms, this normally is affected by one on one counselling with a clinician or by prescription drugs. What Trojan’s Trek has confirmed, certainly by strong qualitative evidence, is the value of shared experience in a remote locality with the tribal elder adopting the role of counsellor or in our case, an experienced veteran. Our definition is that this is a culture specific approach to individual problems. This aspect of the experience is little understood by conventional therapists as they are seldom in a position to observe. Nonetheless, it remains a very powerful tool to be used in the process of problem behaviour recognition and management.
One other aspect of the trek which cannot be applied to conventional treatment is the value of a remote live-in course free from all distractions. This is the inherent value of going bush with a group who have shared similar experiences. Many of you have heard of stories of veterans going bush, and irrespective of each individuals’ reason the common thread is to get away from society and its pressures. To make one point clear, the trek does not advocate withdrawal from society as a solution. That is not generally a viable outcome for a man, his family or partner. The answer is to conform to those society and community standards and live as a productive part of it. The result we seek is to achieve just that. However, we do recognise the inherent advantage of having a captured class with similar backgrounds drinking tea round a dying fire with some smart conversation direction. The old adage, “a problem shared is a problem halved” is pretty much the truth from our experience. The trek is dry.
The other aspect of the trek, although difficult to measure but has a marked effect on the outcomes is the quality and credibility of the staff. Currently we are using Dogs Kearney as the primary facilitator. In this role he excels and has his own way of reinforcing the messages which are generally common at this level and type of behaviour session. The point is, counselling is essentially what we do and although we are quick to distance ourselves from being labelled as therapists, in the true sense of the word some of the staff are just that.
On this last trek Moose included another staff member who has a clinical understanding of why some individuals respond differently to others in the same situations. This now is the domain of a discipline called neuro-linguistic processing, or NLP which adds another arrow to the quiver of trekker tools and exposures us all to the theory.
It has been stated previously we believe that the trek can be replicated given the resources and the will. Certainly in SA we will continue to assist a number of troubled veterans at least once per year providing the funding and other resources are available. That is the mission statement at our level. However, we are also cognisant of the potential benefits which are offered by such a program to the military at large. The question is, do we continue to try to convince the military of the benefits of this approach to stress illness and if the answer is yes, how do we achieve that?
The reluctance or lack of interest which has been so far exhibited by the military is perhaps understandable. Although in the last two treks we have achieved very good qualitative results, the quantitative results as reported in the ACPMH report are not strictly in accord with this trend. There are many explanations for that which I will not pursue here but as Norm Bell would say, “It is a bit like dissecting a frog. All the parts add up to a frog on the ACPMH scale, but they are much bigger when looked at holistically”.
Although this apparent lack of support is frustrating, it is not any particular person’s fault. It is always preferable to take side on the theory or ignorance as opposed to stupidity. However at some stage, given that the veil of ignorance has been removed, our opinion may become more strident to the extent that one may not totally rule out stupidity or perversity.
I would like to spend a few moments explaining one of the issues which the TT staff become quite angry about. As Moose would put it, “is it fair that the military take these young men and women to war and bring them back broken; then turn around and pass that problem to the free market to repair”? In effect this results in a number of young veterans, and I stress the young part, being thrust on an already strained mental health system to the detriment of both the soldier and the community. This is the DVA adopted economic rationalists position of “purchasing services” with virtually no quality control or evaluation measurements at work. The mix of ages in some programs run by both DVA and civilian resources does not engender good results. As a soldier who had completed a course in QLD said, “I have nothing in common with a bunch of old blokes in their 60s and 70s, I could not wait for the sessions to finish”.
This is why I would rather adhere to the ignorance theory as opposed to gross stupidity because if I didn’t I would become angry.
So where to from here?
It is clear to us in SA that this is a long term project which has two quite different objectives. One is strategic, the other tactical.
– If the RAR Association is to continue to support this philosophy it needs to adopt a more aggressive attitude thus focussing on more specific outcomes.
– Efforts to convince the military especially army, that this approach is a valuable adjunct to other forms of treatment will continue but this course must be mapped
– The SA chapter will continue to run the trek to support our veteran brothers and sisters in SA. This will involve some expansion of the base or skeletal organisation
– Long term partnerships with local industry will be forged
– Fund raising will continue based on commercial modelling at state level
– The SA chapter will continue to provide advice to other potential project staff and locations
– Independent data will continue to be collected to back our beliefs
– Funds permitting, data will be interpreted and compared with DVA benchmarks, if available
– Credible research to back our claims will be conducted, hopefully by a PhD student at Flinders University
It is clear that there is room for improvement in the way military stress is treated. Not only is stigma a significant boulder in the path of early intervention, the military by its very nature does not encourage calls for help. And that is understandable but is not in the long term interests of the employees. One soldier was recently reported as saying that he put his humanity and ethics to one side and to operate at the limits of human ferocity. They are strong words but the thrust and message is sound. Do we make enough effort to humanise our soldiers on discharge or indeed after each deployment. If we do not, what is the cost to the family? As Lisa reports, “he was angry all the time and it was directed at me and the kids. It got to the point where if he yelled Samuel (who was four) he would drop to the ground”.
That is all such sad testimony to the way a fine force treats its members and understands the issues. I don’t have the answers but I have lots of theories and I think better ways to utilise the skills humanity has learnt over many centuries. We must retain an open mind in order to heal the cracks in behaviour before they open irreversibly. If we need to call on spiritual beliefs, religious beliefs, culture specific understandings or even mateship, we should be prepared to try them all. There is no one size fits all answer. For some TT may provide the answer, for others God in whatever form may be it. But the message to the military is, don’t close your collective minds and continue to turn your back on your past servants. The answers may lie in a combination of simple theories and practices which are available in your own backyard.
Michael von Berg MC
6 November 2010