I am a counsellor and psychotherapist with almost 30 years experience of working as a therapist. For the last 9 years I have been a full time therapist in an unusual environment for therapy - the welfare department of the Royal Navy and Royal Marines, situated at the naval base in Portsmouth. This has been a voyage of discovery for myself and the clients I have seen, chiefly because of the learning that has taken place - for me about the military ethos, and for my clients about the very concept of therapy that can seem very alien to a military mindset.
Joining the Navy means entering a world where you are invited to give up some personal freedoms in exchange for training, a job where you can explore the world and being part of a community. To belong to the military also means being told how to cut or style your hair, what to wear, when and what to eat, how to exercise and when and where to sleep, to mention just a few of the restrictions the military person encounters.
From a psychological point of view, the group you train and work with becomes crucial because you may need to depend on your shipmates to save your life or give you decisive commands that ensure the smooth running of the ship. The group becomes your 'family', offering a sense of belonging that can be enriching but also, at times, stifling. Conversely, it is this sense of belonging and a shared purpose that can lead to confusion and depression if a mental health issue presents itself. The desire to hide difficult feelings and feelings of 'difference' can be worsened by the physical and mental closeness of shipmates, where the belief that nobody else has the same issues, can prevail.
A young male seaman once told me he sometimes found places to hide on the ship during off duty times because the act of seeming OK was too much for him to maintain on the mess-deck with all of his mates around him. His mother had died nine months before, and he was struggling to come to terms with all his emotions about her loss. A common Naval term for the ability to cope with whatever you are presented with is to 'crack on', while discussing your problems is commonly called 'dripping' and is strongly discouraged.
As a result, those serving personnel and their partners, who came my way, had often bottled up their feelings about loss, relationship breakdown, anxiety or stress for months and sometimes years. This response left them feeling disconnected from family and friends and thus unable to relate to self and others. Anger is a common response to this feeling of disconnection, and many of my clients felt angry with not only those around them, but also with themselves. Stress can also bring on feelings of guilt and self-blame, often because there may be a powerful feeling that others are somehow 'strong' enough to manage emotional pain when the potential client feels they are not.
The partners of sailors and marines often also suffer stress because of their partner spending lengthy periods of time on deployment, and then coping with re-connection problems when their partner returns. Months coping alone with childcare and work and establishing a routine to manage these matters, can lead to feelings of irritation when a partner returns and disrupts this pattern.
The serving person may be unaware of this and also confused that their return has not been as they expected. Separate lives in sometimes difficult circumstances can also bring on fantasies about the relationship that cannot live up to ordinary life - fixing the washing machine can seem very mundane compared to hopes of a romantic reunion!
All of these issues can be exacerbated by trauma suffered while serving. Actual warfare - as shown recently in Afghanistan - where a member of your military 'family' is injured or killed can cause all of the above to be greatly amplified, with images of suffering or physical wounds to return as flashbacks or during sleep-disturbed nightmares.
Guilt, rage and terrible anxiety can all be symptoms of enduring Post Traumatic Stress Disorder, but often they are not understood by a partner who is just pleased to have their other half home alive, even if they are maimed. However, if they encounter a man or woman who seems completely different to the brave sailor or marine they remember, their relief can quickly turn into uncertainty and grief.
Therapy can help with all these issues. Finding a safe non-judgemental space in which to admit to vulnerability allows for military clients to 'name the beast', rather than attempt the emotionally exhausting task of keeping fear and anxiety locked up. Once spoken, problems can often look manageable. Exploring the triggers for grief or stress can allow for understanding to grow, and then appropriate action to take place. The young sailor who lost his mother found comfort in writing a therapeutic letter to her, allowing him to express feelings he had found unable to speak at the time of her death. Relationship therapy can be highly effective, giving both the serving person and their partner an opportunity to understand the issues they are struggling with and enable times apart to feel less challenging.
Trauma can be treated with a specialist therapy known as EMDR - Eye Movement Desensitisation and Reprocessing. This allows the trauma to be less intrusive and means they can integrate into normal life, rather than the trauma dominating everyday experience. All military therapy looks to increase a sense of resilience, allowing the normalisation of emotion, rather than repression of difficult feelings - a reaction that can lead to interference with work and relationships. Therapy with a therapist who understands military life can allow Naval and Marine personnel to find a safe port in a stormy situation and a sense of stability in work and personal life.