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Psychological Help for the Wounded Warrior,
This review is from: Combat Stress Injury: Theory, Research, and Management (Routledge Psychosocial Stress Series) (Hardcover)
Military mental health experts tell us that the "signature injuries" in returning veterans of the Iraq and Afghanistan wars will be posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). If that's true, then books like the present come at just the right time. Both editors of Combat Stress Injury have boots-on-the-ground military experience, as well as being a practicing psychologist (Figley) and physician (Nash), and it shows in their selection of chapters addressing PTSD and related mental health syndromes associated with combat.
The book is divided into three sections. The first covers the biological, psychological, and social aspects of combat stress. The level of detail in these chapters might overwhelm the average mental health clinician seeking a basic summary of stress and trauma psychophysiology, but the comprehensiveness of coverage provides a solid scientific foundation for anyone who still thinks that "stress" is some airy-fairy concept cooked up by mental health academics with too much free time. Indeed, a theme that runs through this book is that an adverse reaction to the experience of combat should not necessarily be seen as a "disorder" per se, but rather represents a psychological injury as real as a fractured skull or amputated leg. Also discusse is the individual variability of resilience: why some service members succumb to combat stress injury, while others seem to adapt, and a few even grow stronger.
The chapters in Section II offer a set of studies, including one on the delayed effects of combat stress on long-term mortality, i.e. combat stress can act as a sleeper weapon, coming back to bite the veteran at the tail end of his or her life. Another chapter debunks the clinical myth that physical injury mitigates the effect of psychological trauma supposedly because the veteran now has something "real" to justify his disability. If anything, the research shows that physical and psychological injuries are additive: one worsens the effect of the other, and each needs to be taken seriously. Trauma leaves a wide wake, and a third chapter in this section reports on the effects of secondary traumatization on spouses of injured veterans.
Section III details a variety of prevention, intervention, and treatment programs for combat stress injury being field-tested for use with military service members. These include medication management, peer support programs, experiential treatments for combat stress, virtual reality applications, a comprehensive trauma risk management (TRIM) program used by the Royal Marines, the utility of using friends and families as resources, and the role of spiritual counseling.
No book has everything, and I would have liked to see a chapter or two on applications of individual counseling and therapy approaches to combat stress, which would be of most interest to practicing clinicians who treat military veterans and service members. But this book is a great place to start for professionals who are serious about understanding the unique tribulations of our uniformed service members who live with the prospect of death and disablement to preserve what we all value.
- Laurence Miller, PhD, International Journal of Emergency Mental Health
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