Dr. Kate Hendricks Thomas is a speaker, researcher, and storyteller. She is the author of several books on military health. Hendricks Thomas, also a U.S. Marine Corps veteran, helps businesses and military veterans optimize their performance through resilient leadership training. Her behavioral health research has been published in journals like Traumatology, the Journal of Military and Veterans’ Health, and Gender Forum.
As a military health researcher, I hear veteran women tell me all the time that they sometimes feel invisible. The Service Women’s Action Network is calling for active duty, reserve, Guard, and veteran women to help change that.
Take our 2017 needs assessment and help government, community, and advocacy groups develop THE RIGHT programs to meet the needs of military women past, present, and future. The survey is short and easy, and it will help us make our community’s diverse voices heard.
Our assessment last year helped us understand and share information about belonging and support – it shed interesting light on the need for service organizations to open their doors to women in new, inclusive ways.
You see, women veterans share many of the exact same concerns as our male colleagues; yet we also face unique issues, especially when it comes to accessing services after we leave active duty.
Some of the most important places veterans connect, network, and socialize while transitioning our Military and Veteran Service Organizations (MSOs/VSOs). However, our team’s latest research in the Journal of Veterans Studies indicates that women veterans participate less and even report feeling unwelcome in those very spaces.
Be part of the solution this year by taking the survey! Military women are some of the most resilient leaders you’ll meet, and you can change our reintegration experiences if you help make that visible.
I used to think I understood health. I worked in fitness and told people about it for a living. I WAS WRONG. Focusing only on movement and nutrition, I was missing the bedrock concept upon which real health is built. We are wired to connect and social health is the foundation of human well-being. (Check out the science behind this in my just-released TEDx talk).
This is what I study today, but in a life quite different than my current as a suburban mom and public health professor, I was a Marine Corps Military Police Officer. I have a little brother who also joined the Marines and we’ve always been very close, probably because we had to be! When we were young we moved over 20 times – there was many a summer where my siblings were my only friends because we were the new kids.
I was already deployed to Iraq when he e-mailed me to share his grand romantic plans to propose to his girlfriend before he headed over. She was a civilian schoolteacher that I had yet to meet. I was in my cynical deployment mode and I was surrounded by Marines receiving what we call “Dear John” letters. They often read the same, “the grind of deployment is too much, our relationship is over, I already have a new significant other, the end.” I didn’t think his proposal would wind up any differently because he was headed to Iraq right behind me, but I wanted to be supportive so I told him I didn’t have a problem with the proposal but admonished him to buy her a ring made out of cubic zirconia. No sense in buying a diamond he might never get back.
As younger brothers often do, he ignored my advice and bought her a beautiful ring.
Well, that is some cash he will never see again! Should have listened to me!
When he was coming in I had convoyed south and I was able to be there at the hangar in the middle of the night when he flew in. Even armed and incredibly well-trained my brother will always look like a little kid to me. He was walking towards me with a huge pack on his back, a Kevlar on his head, and a rifle in his hands. All I could see were his big, blue eyes peeking out like a turtle under all that gear and I thought, “who let a ten year old on the plane with a rifle???”
As I stood watching his C-130 unload on the tarmac I forgot to feel invincible for a moment and my heart sunk – I knew where he was heading and I knew what was happening there. I had some big sister notions of telling him what he needed to know to stay safe during his deployment and for the first time it occurred to me that may not be enough.
Soon after I was headed home to the states and I didn’t know it at the time, but he was as well. Except that an improvised explosive device made sure that his trip home was wounded and on a stretcher.
When a service member is medically evacuated and they make it to the stateside hospital, there are no guarantees and a lot of unknowns.
When my brother arrived at Bethesda, we didn’t know what he might be facing. Our family came together to be there for him, but even with our support system gathered, Bethesda was a dark place some days.
Into this world walked my brother’s civilian schoolteacher.
Frankly, I didn’t yet know if she was part of our close-knit family. I had stereotyped her on sight—mostly because she was a pretty girl who often wore makeup and always had on matching accessories. I was waiting for her to fall apart.
She never did.
When her leave ran out at work she went back to teaching all day long in nearby Virginia, but made the drive every night to sleep in a chair at my brother’s bedside. I was terrible in that hospital room always dropping things – just graceless. She kept him smiling and focusing on their future together. She kept him connected to their community of friends when he left the hospital and had to spend his days in a reclining chair. She kept him looking forward to new plans to build a family, even when they had to install bars over his bed at home and he needed help with the most basic tasks.
That makeup had fooled me; she was more than serious. She showed up, and she was a foundation for my little brother when he really needed one.
They got married and she gained three sisters that would help her hide a body today if she asked.
She has a really good memory though. Every now and again, I hear about that cubic zirconia comment.
The Science of Social Cohesion
Here’s the truth about human health – nothing will kill you faster than loneliness.
We know all of this because scientists have studied social cohesion from a variety of angles and proven that disconnection is dangerous! We’ve studied partner relationships, friendships, and civic involvement – it is all important and comprises our social health. In one study, medical students without many friends had depressed immune systems. A 30 year study out of Roseto, PA found that support protected against heart disease even when the diet wasn’t ideal. My own research has demonstrated convincingly that people without partnerships are at greater risk for depression.
We talk in public health about behaviors that offer something called protective effect and upping your social support has more protective effect than quitting smoking. Don’t hear me wrong – smoking is still bad!
The reason for that can be found in our physiology. Stress hormones surge when you’re feeling lonely or rejected, and if this happens too often or for too long, you start seeing problems.
Cortisol and adrenaline are useful when facing a real threat – they fire us up to respond, but they also shut down everything non-essential. Our heart rate and our breathing rate jump up and blood flows to our biggest muscles. Energy to the logical brain, digestive system, and even blood flow to our extremities is diverted.
If hormone levels stay up, you can imagine the problems your body starts to face. At first, diminished blood flow to the extremities is just cold fingers and toes. Over time it might become neuropathy. Then, you stop feeling and have trouble picking things up or even balancing – in this way our body is trying to signal us – loudly, in the only way that it can – social numbing becomes physical numbing.
Our brain activity being interrupted may mean initially only that it becomes tough to find our car keys. Soon enough, we begin to have difficulty communicating, displaying empathy, or engaging in high-level thinking. This makes connecting with others even more challenging, and our isolation can easily become self-perpetuating.
I work in military public health today, and for a long time, all we talked about was the correlation between post-traumatic stress and combat deployments. That’s not the whole story, though – it’s far too simple. The riskiest time for veterans is the first six months of coming out into the civilian world. We face that complex mix of losing identity, our purposeful, all-consuming work, and the biggest loss – our tightly-bound community.
Conclusion: So-What Factor
When social support is happening the way we want it to, you get a veteran reintegration story like my brother’s. In our family, he is still everyone’s favorite. He’s now a dad and a slightly-intense High School English teacher. His wife is hilarious and keeps us all on our toes.
When it’s not, you get one like mine, and like too many of our service members leaving active duty today.
I struggled with pulling the right people around me after deployment and that time at the hospital. I was angry, guilty, then angry some more. I drew inward and sought to surround myself with people who had similar experiences to my own.
The results for me weren’t pretty. I worked too hard, drank too much, and communicated not at all. I found a relationship that was as volatile and crazy as I was feeling on the inside. I didn’t know the meaning of the word “introspection” or the phrase – ‘I need help.’” There was a time I could’ve wound up an isolated, angry statistic.
The social health issues I’m talking about aren’t strictly veteran problems. The angry veteran, the elderly shut-in, and the person in an emotionally abusive relationship all deal with the same physical effects.
All of us have to prioritize it.
I was never lonely exactly, I certainly had people around me, but I had too many of the wrong people, and I had no one who ever challenged the way I was doing things.
We all need the strength that an uplifting group of different – and thus complementary – personalities brings us. So I had to ask myself, as I encourage you to ask yourself – how are my people?
Do they support you? We need affirming, yes.
Do they challenge you? We also need different.
Connect. Be willing to get a little uncomfortable – It can completely change your health.
Despite the vast news coverage of the wars in Iraq and Afghanistan since 2001, one figure has remained mysterious: the number of suicides among US servicemen and women, compared to combat casualties. Here’s one statistic to contemplate: In 2012, the US military lost 295 soldiers, sailors, airmen, and Marines in combat in Afghanistan. But over this same time period, 349 took their own lives.
Right now, we are losing more veterans to suicide than to combat. I’m a pretty decisive person with limited ability to ask for help and zero trouble-taking risks; there was a time I could have become one of those statistics.
Those figures are mysterious because even as we throw money and resources at clinical mental health treatment and blame rising rates on multiple deployments, the answers are elusive. The narrative of the “broken veteran” struggling with combat stress just doesn’t ring quite true to those of us who served over the last decade, and the issue is more complicated than simple statistics can show.
I became a Marine to serve, and I loved being part of the Corps. As with anything I have ever loved intensely, the military changed and shaped me. To the casual observer looking in, the world seems brutal and intense. That casual observer isn’t entirely wrong—the military is some of those things. Shared hardship and challenge are vital parts of the refining and rebuilding process that changes a civilian into a warrior. If you ask anyone who served, they wouldn’t have it any other way. No one wants what comes easily or is handed to just anyone.
That process of obstacles, mastery experience, and shared suffering offers growth and transformation, but coming back to civilian life afterward can be incredibly hard. Standards are different. Camaraderie is different. Culture is absolutely different. I witnessed firsthand the toll that leaving the service took on many of us.
Stressful work environments, high rates of divorce and domestic violence, family separation, and repeated combat deployments all contributed, but the biggest reason for the reintegration problems many of us faced is cultural. We subscribe to unbalanced notions of what it means to be a warrior and uphold silent suffering as a virtue. Mistakes are shameful; pain is weakness. Saying that something is hard or stressful just isn’t done.
I don’t want to contribute to the silence that surrounds these issues anymore. Too many aspects of warrior culture are destructive lies we tell ourselves.
Who are we maintaining this veneer for? What do we have to prove anymore?
Constant invulnerability is an illusion, and cultural mandates to be “together” in every way become dangerously prescriptive. We lose our authenticity in this way; we don’t know how to reach out to each other when stresses start to overwhelm us. Too many of us who are used to appearing strong would, indeed, rather consider suicide than admit to being human, fallible, or broken.
My own public story was of crisp uniforms, physical fitness metrics, and successes. I always looked good on paper. My private story involved destructive choices, broken doors and holes in the walls, hiding weapons in the house, and getting dragged across the living room floor by my hair. I was as far from God as a person could be but had no idea at the time.
As a Marine Officer, I was not supposed to make mistakes, feel depressed, or need help. But I did. Tough places and situations became tougher because I didn’t know that people might be okay with an imperfect version of me. For too long I chose silence over reaching out to loved ones. I opted for deeply felt, visceral shame over openness and vulnerability.
When serving in the military we are trained to lead with confidence. Presenting a certain and effective façade requires some incredibly useful skills. We make decisions quickly and responsively, but these very same skills become incredibly destructive when we never learn how to turn them off. This description fits most service members. We tend to be a driven, almost comically dysfunctional, lot.
What if I told you that I am not perfect?
What is so useful about sharing our experiences with one another is that we offer each other the opportunity to say that kindest of phrases: “Me too.”
We are not alone.
The determined avoidance of care-seeking I lived through is disturbingly normal in the military community that I call home. For me, learning to do better involved stumbling by accident into the three key components required to build human resilience. My later academic study brought a wry smile to my face as I realized that the answer had always been there; I just hadn’t known it when I needed to.
What if I had training in resilience before hitting rocky shoals?
To get to a healthier space, I had to make some hard choices, choices that involved leaving destructive patterns and people in the rearview mirror. It felt like dying to do so, but it allowed me space to breathe and to focus on becoming a new version of myself. Once I deliberately and consciously began stepping outside old patterns and belief systems to connect with and serve my community, embrace a healthy lifestyle, and seek and find an authentic relationship with God, the world stopped spinning in quite such an unforgiving fashion.
It wasn’t a chaplain or a counselor who pointed me in the direction of wholeness, though I certainly tried those routes. I keenly remember sitting in my first counseling session with a well-intentioned professional, answering her with short sentences and half-truths. While I have great respect for clinical mental health practice, many of us are not interested in embracing the identity of a patient. I never was. I sneered at things that would have been really useful!
You can keep your couch.
I’m a true nerd at my core, and when the dust cleared in my personal life I became motivated to learn all I could about how we as veterans are talking about mental health. I went back to school for an interminably long period of time and threw myself into community-based programming and health promotion. When I really drilled down in my issue analyses, I didn’t much like what I found. We are killing ourselves alone in apartments and no one is seeing any symptoms—we are that good at hiding out. It really isn’t that services aren’t available to veterans and military personnel when things become difficult, we just won’t use them.
No matter what magic we do in the clinical realm, focusing on treatment requires a disempowerment narrative that is perceived as being incompatible with the cultural values of military veterans. We cannot overcome such norms by asking warriors to become patients and pop pills, no matter how dedicated, innovative, and gifted the clinician is. While treatment is certainly part of the solution, it is not culturally acceptable for it to be the entire answer.
I know this to be true on both an academic and a personal level and believe we need to alter the dialogue about resilience. We must flip the current paradigm and turn words that currently connote weakness (like authenticity, self-care practices, and social cohesion) into training mandates and metrics of performance.
There is tremendous work to be done.
Trying to do that work is a translational team coming together at the 2016 Service member to Civilian Summit. S2C brings together researchers, practitioners, government employees, veterans, and military-connected family members to talk about best practices and processes to improve veteran health and reintegration. Speakers include field leaders like: