Practical Therapy for Soldiers' Depression

Soldiers, especially male soldiers in or anticipating combat, need time and the confidence to cry, resolve their fears, acknowledge their shame, and deal with their other emotions.
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In response to the Army's plan for mass therapy (NYT, A1, Aug. 17) my previous blog outlined the basic causes of depression: hiding emotions and no secure bonds. How can we confront these problems? My first suggestion is to have each soldier compile a list of the Best Moments in their whole lives. Here are three early examples from my own personal list (now up to sixty):

1936-- In second grade in Kilgore, Texas, teacher asked if anybody knew what happened in Ethiopia last week. Mine was the only hand raised. I said it was invaded by Italy. She asked, how did you know? I said, I read it in Time Magazine. She looked at me as if she were seeing me for the first time. .

1938-- Class play in the 3rd grade. We had many rehearsals for a play about the Declaration of Independence that our class was to present to the entire school. I played Thomas Jefferson reading the Declaration of Independence. But in the actual performance, there was a surprise for me. The teacher had arranged for a pianist to accompany me with My County Tis of Thee. I felt that the music helped bring my words to life.

1943-44-- To my surprise and delight, I found I was treated with respect by the scoutmaster and his wife in Leesville, Louisiana. I felt that I had at last found my real home in their house and in the troop, the place where I belonged.

Exercises

1. Best Moments: List memories of times where there was deep contentment and/or a secure bond with at least one other person, or better yet, a sense of community with a group. Explore each memory at length, to the point that you feel genuine pride. Depression should lift at this time, if only temporarily. This step, when it works, provides a powerful incentive for further explorations. Men particularly find that they can learn to cry in this way. (Think of the photos of all three Olympic track winners crying on their pedestals when they receive their medals.)

2. Gratitude Letters: Compose letters to all those persons in your life, alive and dead, to whom you feel especially grateful, Martin Seligman's idea. This exercise, in conjunction with Best Moments, also helps men to learn to cry.

3. Try to form an empathic emotional union with at least one other person, by hook or crook, no matter the content. Get off topics, into relationship talk. Anything that is not happening in the moment is topic talk. An example of relationship talk is "I didn't understand what you just said. Could you repeat it?" or "You seem sad," "I am proud of you," "You seem distracted," and so on. Relationship talk is about what is happening in the moment, to either person, or between them. For most people, it is very difficult to avoid topic talk.

4. When you feel connected to your confidante, or secure enough to do memory exercises by yourself, remember and re-experience unresolved shame and other emotional episodes to the point of acknowledgment.

Acknowledgment means verbal recognition of an emotion state accompanied by the actual experience of that emotion. Most of the confessions of shame in Alcoholics Anonymous meetings don't qualify, since they seem to be merely verbal.

Unacknowledged grief provides another example. I heard a woman at a party saying that she stays on anti-depressants because she gets "weepy" when she goes off them. Perhaps she needs to cry. There is a detailed description of a situation like hers in Iris Dement's song, No Time to Cry (1993):

My father died a year ago today,
the rooster started crowing when they carried Dad away
There beside my mother, in the living room, I stood
with my brothers and my sisters knowing Dad was gone for good
Well, I stayed at home just long enough to lay him in the ground
and then I caught a plane to do a show up north in Detroit town
because I'm older now and I've got no time to cry
I've got no time to look back, I've got no time to see
the pieces of my heart that have been ripped away from me
...
I guess I'm older now and I've got no time to cry...

Soldiers, especially male soldiers in or anticipating combat, need time and the confidence to cry, resolve their fears, acknowledge their shame, and deal with their other emotions. For this purpose, they also need a secure bond, perhaps first with a therapist or teacher, then with a buddy. Experiencing emotions head-on and securing bonds has worked well for me and for a majority of my students for the last 20 years. It might also work for the Army.

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