PSYCHOTHERAPY WITH VETERANS

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PSYCHOTHERAPY WITH VETERANS

• Professor Dave Mearns
• University of Strathclyde
• www.davemearns.com

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• Mearns, D. Cooper, M. (2005). Working at
  Relational Depth in Counselling and
  Psychotherapy. London Sage. ISBN 0-7619-4458-3

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• Carl R. Rogers J. L. Wallen (1946)
  Counselling with Returned Servicemen. New York
  McGraw-Hill.

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• Trauma is a profoundly existential event

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• Trauma fundamentally disrupts the whole
  assumptive frame upon which our sense of self is
  founded (Mearns Cooper, p. 65)

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• Trauma is so shocking at an existential level
  that it can take us completely out of our social
  worldThe trauma victim may find it difficult to
  perform the simple acts of social living even
  shopping in a supermarket can become impossible
  because of its essential meaninglessness...It
  becomes difficult to tolerate insignificance when
  something so profoundly significant has happened
  to us. (p66)

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THE BUZZ

• This event was simultaneously the worst thing
  that ever happened in their life and also the
  point in their life when they felt most alive
  (p67)

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• In working with a patient experiencing trauma,
  the therapist is challenged to meet them in the
  pain of their experiencing.

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TRAUMA IS STICKY STUFF

• SECONDARY TRAUMATISATION

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• TRAINING IN COUNSELLING AND PSYCHOTHERAPY
• Emphasis on personal awareness and development

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• SUPERVISION IN COUNSELLING AND PSYCHOTHERAPY
• Emphasis on maintaining the health and the
  development of the practitioner

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PERSON-CENTRED THERAPY

• Originator - Dr. Carl Rogers
• Putting humanity back into therapy
• Characterised by
• Valuing
• Empathy
• Genuineness
• A depth of relational contact

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Meeting the patient at the edge of their
experiencing

• at the edge between the known and the unknown
• where the persons systems of self-protection
  struggle to contain the raw experiences
• where the struggle for sanity divides the self.

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• I generally had two answers to every question
  one set that I gave to other people to pretend
  I was OK and the other set that I could rarely
  voice

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• My wife loved me and cried when she visited.
  That was too painful. I couldnt cope with
  myself, never mind another person. So I told them
  not to let her come again.

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• During the day I had lots of routines to keep
  the devil away. But at night he got me. Every
  night I would try to stay awake. But every time I
  fell asleep I was opened up with a knife and my
  guts would fall out. I would try to pick them up
  to carry them to get help but they kept
  slithering on to the pavement.

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• I really wanted to speak to you you seemed
  a nice enough guy I wanted to give you
  something back. Sometimes, in my mind, I would
  open my lips and try to speak but, in reality,
  my lips didnt open I couldnt make them open

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• One of the things that made the difference
  for me was that I couldnt get rid of you. I
  would do everything that should make you give up
  on me but you kept coming.

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Earning the Right to work with Rick A
Traumatised Client

• Chapter 6 in Mearns Cooper (2005) Working at
  Relational Depth in Counselling and Psychotherapy.

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THE HOSPITAL

• Therapy based regime
• Non-military therapists
• Daily working
• 3-4 patients
• Daily supervision
• Trying to get contact
• Prognoses

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RICK

• Fire fight
• Fragging
• Third tour
• Mute

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The first of 72 meetings over 12 weeks

• RICKS ROOM
• RICKS SILENCE
• MY WHO I AM SPEECH

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MEETING 2

• RESPECTING AND CONNECTING

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• ENCOUNTER NOT INVASION

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• RICKS TURNING ROUND

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• MAINTAINING OUR HUMANITY IN THE ABSENCE OF
  RESPONSE
• What I did get back from Rick
• Staying fresh
• The rap group
• Supervision.

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• TALKING THE TALK

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MEETING 15

• THE FLYING BOOK

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MEETING 23

• THE DAY RICK CRIED

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MEETING 25

• TELL HIM NOT TO COME

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MEETING 26

• THE DAY DAVE CRIED

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MEETING 27

• DO YOU TAKE CREAM OR SUGAR?

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• THE END OF THE BEGINNING?
• OR
• THE BEGINNING OF THE END?