After 20-plus years of veteran suicide prevention efforts have failed to reduce the rate of tragic suicides, the Warrior Healing Center (WHC) is doing truly different things to address the problem--with great success. But what makes WHC Different?? For starters, we recognize the past failures and are willing to challenge assumptions and methods that have proven ineffective. We started in 2018 with a "clean sheet" approach, drawing upon cutting-edge science and personal experience to imagine better ways of responding to the problem--without spending tons of money to do it. The result is now making a dramatic difference in the lives of many, and while we never say that a suicide has been prevented or that a veteran in crisis has been "saved", we see the remarkable difference every day in the faces of real veterans with real struggles. But what is wrong with the vast majority of current clinical approaches or "mountaintop high" retreat programs that have made zero impact on veteran suicide rates for decades? The problem begins with the lack of understanding behind these approaches.
To truly grasp the multifaceted and nuanced nature of veteran suicide, we must consider the pathogenic factors and forces that cause it. Our work proceeds from the pathology of suicide, with a focus on the human soul as the center of the malady rather than mental illness. While the mind certainly plays a role, we find that acceptance of the existence and vitality of the soul is the price of admission to any serious discussion of the problem. The soul contains what we think of as the "self", and loss of self is the pathway for the suicide problem. Elements of the self include personal identity, purpose and meaning, and external environmental erosion factors that erode the self. The pathology of suicide hinges on isolation of the self, and without personal isolation, we see very little suicidal thinking. Our goal is to build a framework to better define intervention stages particularly when they result in advanced suicidal ideation.
Suicide pathology involves an erosion of health driven by stages over time. Early risk factors – post-traumatic stress disorder, depression, substance abuse – are often magnified by the gradual loss of identity and mission that can follow a military career. For a veteran, getting out can trigger the first of several potentially vulnerable phases in which that sense of meaning and mission is gone, not only the mission, but the problem-solving, risk-taking, and a purpose-filled military career itself. A fragmentation of the self is a key precursor to suicidal ideation.
Military life can have an all-consuming structure and sense of identity, alongside a consistent – if often dangerous – purpose. After leaving the military, a feeling of existential loss can result in an emptiness and a void that is difficult to overcome. Many veterans struggle with questions about purpose, value and belonging – which in turn can lead to feelings of self-doubt, hopelessness and worthlessness. Interventions that specifically address this aspect of disenfranchised grief focus on program offerings helping veterans reintegrate with new meaningful pursuits that can help balance the loss of their former goals, structure and sense of purpose. This reflects a lifelong cycle of invigorating the soul through human relationships and activity. This means that while introspection, self-help, therapy and clinical treatment have their places, durable answers to the veteran suicide problem are found in the veteran's community. Authentic community feeds the soul with vital nutrients: love, hope, and a sense of belonging.
But authentic community can be elusive. While social media can theoretically be a source of support and connection, it can actually have the opposite effect, leading to feelings of isolation and inadequacy. Virtual lives shared with others through social media can reinforce veterans’ feelings of isolation and inadequacy as they navigate their transition to civilian life. The comparisons with others on social media can reinforce veterans’ crisis, intensifying their isolation and eroding any sense they have of being understood by their peers. Social media becomes "fast food for the soul" that gives a sense of community satiety without delivering the vital nutrients the soul needs to survive.
This is not to say that clinical approaches or mental health treatment have no place in helping veterans deal with life after the military. In the late stages, multi-step intervention, with a combination of therapy, drugs and social interaction can be effective. CBT and other in-house treatments can help veterans interpret their experiences differently and foster new coping strategies. Peer-support groups can also be especially helpful in these situations. It’s important for veterans to share their stories and develop a camaraderie with other veterans. It’s also crucial to catch and treat any co-occurring disorders, such as PTSD and substance abuse in late stages, because all these conditions compound mental stress.
But these approaches don't deal directly with the soul or the moral injury that often accompanies military service. ‘Disintegration of the soul’ refers to the devastating disruption of inner balance that results when the subjective sense of self is destabilized by the catastrophic loss of that which makes a person who they are. Veterans may experience ‘disintegration of the soul’ after traumatic exposure and the loss of the routines that structured their lives. The conventional view in suicide prevention – that the answer is to engage and treat mental illness – often leads, if not directly, to the erosion of the veteran’s soul, and can sometimes even exacerbate the already-acute suffering by doubly neglecting purposeful living and the need for connection.
In sum, a multifaceted understanding of, and approach to, veteran suicide is necessary to develop and implement effective strategies for its prevention and intervention. That is the WHC difference. We use methods that deal with moral injury, loss of self, and soul resuscitation that direct address the root causes of suicide. Recognizing the important role that identity, purpose and social environment play (including social media) can help to provide a comprehensive, empathetic and effective framework to reduce veteran suicide. Ultimately, only by addressing these interrelated issues will we be successful in reducing veteran suicide and giving our heroes a leg up to survive and thrive once they return to civilian life.
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