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Dennis Higgins
Adelphi University
VETERAN MINDFULNESS 2
In two years of working in the New York VA Health Care system, I found that in
almost all of my cases, I was teaching veterans elements of mindfulness. Many of the
veterans who came into my office found themselves unable to identify or express emotions
in a direct or healthy manner. This was often the product of their upbringing, reinforced by
the military. This required some training in order to become aware of their bodies and
friends) are interrupted during the basic training process, where trainees are sequestered
at a base, often far from home, and unable to see friends or families until the training
process is completed (Hayden, 2000). This expands the trainee’s interactional experiences
by including new people and new places and creating a greater tolerance for diversity
(Elder, 1987). The structure of tasks in basic training, in addition to teaching the
fundamental skills service members require (Hayden, 2000), force unit cohesion, which is
predictive of higher psychological mediators and lower negative mental health measures in
recruits, as well as higher levels of resilience (Williams et. al, 2016). The indoctrination into
the military provides a level of institutional support as well. In knowing that their basic
needs will be met, service members gain a level of security and investment into the military
culture (Kelty, et. al, 2010). Resilience to adversity is built through hardiness training on an
(Lovering, et. al, 2015; Maddi et. al, 2017). The military environment, then, is experienced
VETERAN MINDFULNESS 3
as a family who takes care of the service members and creates a structured set of
total—with uniform haircuts, clothing, and prohibitions on contact with outside world, the
The transition into the military focuses as much on changing internal cultural views
as it does on specific task and physical fitness training. This warrior ethos is crucial for
maintaining an effective force and behave in ways that show perseverance, responsibility
for others, motivation by a higher calling, and an ability to set priorities, adapt, and work in
a team environment (Redmond et. al 2015). The identity created by military indoctrination
is infused with values of duty, honor, loyalty, and commitment to comrades, unit, and
nation (Demers, 2011; Redmond et. al, 2015). In addition, that identity emphasizes
personal responsibility, health, training, and self-improvement (Kelty et. al, 2010). The
the expression of members’ personality characteristics and how veterans view their service
enlisted (DeVries & Wijnans, 2013). That said, while there are no doubt characteristics that
lead certain citizens to enlist compared to others, civilians who were given hypothetical
moral challenges similar to those that exist in current military operations answered
Bessel van der Kolk (2014) discussed how traumatized people are afraid of feeling.
The anxiety that comes with the constant feeling of threat creates constant physical
sensations that prepare the body to defend itself. In combat, this is a wonderful trait.
VETERAN MINDFULNESS 4
Hyperarousal, while a criteria for PTSD in the civilian sector, is necessary to survive
combat. The military culture is one of hypermasculinity. As such, there is a focus on doing,
not feeling. Grossman and Christiensen (2008) discussed the nature of military
indoctrination is such that service members look forward to combat, honing their
behaviors and instincts to gain mastery in their martial arts. These behaviors and instincts
civilian society without refocusing. As these behaviors are often unconscious reflexes, the
cultivation of mindfulness practice is important to first draw attention to the behaviors and
emotions, and then learn to experience them all in real time, without judgment.
ways—attention and compassion. These are both vital for veterans to understand and I will
When using mindfulness as attention training (Morgan, et. al, 2016), there are
generally three goals that come from mindfulness mediation: focused attention, open
monitoring, and loving-kindness and compassion. The first is actually very easy to develop.
Many veterans will have learned to focus their attention on a task. In some ways, being on a
rifle range, focusing your breathing, monitoring your trigger pull, ensuring you are in the
proper position, and aiming at a target is a very specific form of focused attention
meditation. It cultivates an awareness of the body in relation to your rifle and the target
Open monitoring is a little more difficult and loving kindness and compassionate
mindfulness is the most difficult. Compassion for one’s self is not part of the military
mindset. In fact, it is actively suppressed in service of the other. Your teammates and the
VETERAN MINDFULNESS 5
mission are more important than you are. This is something instilled during the
indoctrination process and, as there is no process of reintegrating back into civilian society,
stays with many veterans upon discharge. The level of self-criticism that veterans place
squarely on the service member’s shoulders and mental health problems are seen as a
personal weakness, not as an injury. The loving-kindness meditations that Morgan and
colleagues (2016) suggest would be a very tough sell on a veteran without preparation. In
some ways, it is first necessary to bring the veteran’s attention to how his mindset was
both useful in combat but troublesome back home. In many ways, there must be
considerable psychoeducation done before the veteran is ready to undo his self-critical
mode of thinking. What needs to happen is an understanding that safety will be ensured
with this new way of thinking. The military mind is a survival mind, tied to the deepest
regions of the reptile brain. These skills, this mindset, is explicitly designed to enhance
survivability on the battlefield and that is the main focus of military indoctrination. Once
safety is established, then we can start undoing that self-criticism and replacing it with
loving kindness and self-compassion. It is vital for the clinician to be attentive to the
veteran in this stage, as the veteran will be moving into a new, vulnerable emotional
I can discuss this in practice by using a patient at the Brooklyn VA I will call The
Dreamer. Throughout all of our treatment I cultivated mindfulness through direct inquiry,
compared to a more meditative style (which I believed he would be resistant to). The
Dreamer entered treatment in order to treat his nightmares, which reflect his vulnerability
and aggression. Getting him to be more comfortable with his vulnerability required
VETERAN MINDFULNESS 6
exposing him to aspects of it in a safe, controlled manner and showing him that he can
survive being vulnerable. The aggression he feared would also have to be explored in full.
He usually began every session discussing a dream he had over the previous week before
After hearing his dream, I would ask the Dreamer how he felt discussing the dream
in the present time as well as how he felt when he woke up from it. Comparing the
reactions between then and now can be useful for showing the patient that negative affect
is transient. Then I would ask him what he thought the dream meant. This would give me
an idea of how self-aware he was about the symbolism inherent in his dreams.
Since many of his dreams have ambivalent relationships with medical personnel, I
would ask him how he feels about coming to mental health treatment. I’d ask him his
opinions of the medial personnel that he has encountered at the VA and, in particular, his
opinions of myself and other mental health staff he has worked with. His dream
relationship with medical personnel is often contentious based upon the personnel doing
something that puts the Dreamer at risk. I would discuss with him the risks he feels about
discussing his history with me, as I felt his reluctance to share his emotions is based upon
that fear.
slow but had positive results. After he detailed one of his dreams where he was being
chased by an unusually persistent and intelligent snake, I asked the Dreamer what he
thought might be chasing him. To this, he responded, “I’m chasing myself,” which I thought
was a very insightful response. This encouraged me to ask him about many of the more
prominent features of his dreams. In one, where a taxicab driver who was supposed to take
VETERAN MINDFULNESS 7
him to see me, the taxicab driver frequently misunderstood the Dreamer’s directions
(which were to a different hospital than we see each other at). When I asked him why he
thought the taxicab driver had trouble understanding him, the Dreamer replied, “people
don’t understand where I’m coming from most of the time, anyway.”
We terminated after about a year of therapy, when I left the hospital. While The
Dreamer acknowledged he could probably benefit from more therapy, he said he didn’t
want to start over with a new therapist and that he felt he was much more in touch with his
feelings and was able to understand his anger and he reported no nightmares for the last
two months we were in treatment together. By creating a more mindful veteran, I was able
References
Blais, A., & Thompson, M. M. (2013). What Would I Do? Civilians’ Ethical Decision Making in
Doi:10.1080/10508422.2012.748634
DeVries, M. R., & Wijnans, E. K. (2013). Personality and military service. In Military
Psychologist’s Desk Reference (pp. 26-30). New York, NY: Oxford University Press.
Elder, G. H. (1987). War mobilization and the life course: A cohort of World War II
Grossman, D., & Christensen, L. W. (2008). On combat: The psychology and physiology of
deadly conflict in war and in peace. Millstadt, IL: Warrior Science Pub.
organizational socialization. Carlisle Barracks, PA.: United States Army War College.
Kelty, R., Kleykamp, M., & Segal, D. (2010). The military and the transition to adulthood. The
Lovering, M. E., Heaton, K. J., Banderet, L. E., Neises, K., Andrews, J., & Cohen, B. S. (2015).
Maddi, S. R., Matthews, M. D., Kelly, D. R., Villarreal, B. J., Gundersen, K. K., & Savino, S. C.
(2017). The Continuing Role of Hardiness and Grit on Performance and Retention in
Morgan, W. D., Morgan, S. T., & Germer, C. K. (2016). Cultivating Attention and Compassion.
Redmond, S. A., Wilcox, S. L., Campbell, S., Kim, A., Finney, K., Barr, K., & Hassan, A. M.
(2015). A brief introduction to the military workplace culture. Work, 50(1), 9-20.
Doi:10.3233/WOR-141987
van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of
Williams, J., Brown, J. M., Bray, R. M., Goodell, E. M., Olmsted, K. R., & Adler, A. B. (2016). Unit
cohesion, resilience, and mental health of soldiers in basic combat training. Military