Trauma Recovery

Veterans, PTSD, Suicide, and Hope

July 19, 2021

Answers and support can’t come fast enough when it comes to Veterans, PTSD, and suicide.

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When it comes to talking about military veterans, Posttraumatic Stress Disorder (PTSD), and suicide, nothing is simple. What is known is that these three categories are connected in complex and tragic ways. Whereas knowledge increases each year thanks to new research and systematic observation and discussion of clinical implications and treatment outcomes, the inherent complexity within each of these categories means that their interactions are still largely a mystery. Deborah Huso examines many of these conundrums in her article “Sharing the Burden” for this September’s Military Officer magazine.

The discussion begins by noting that we’re not going to be able to make clear assumptions about suicide when assessing veterans as a broad group. After all, within this group are multiple variances: branch of service, Military Occupation Specialties (MOS) or job performed, a number of deployments, combat, and direct combat experiences, among many others. We are also not going to be able to draw perfect generalizations or find clear lines of distinction between individual case studies. As one source quoted in Huso’s article says: “No two deaths are alike.”

That same source— Jackie Garrick who serves as acting director of a suicide prevention office in the Department of Defense (DoD)— goes on to point out that seemingly important risk factors for suicide might not be as relevant as they seem at first glance. A DoD report cited in the article indicates that people with a history of behavioral disorders, for instance, comprise a smaller percentage of completed suicides (about 45 percent) than those without such history.

Through research, we are able to better account for variables that may be overlooked or overinflated by pure numbers. For example, the raw data suggest that non-deployed veterans may make up a larger percentage of suicides than those who had been exposed to combat firsthand. However, deployment status records reveal there are more non-deployed veterans than combat-deployed veterans, to begin with. Research can aid analysis by making the raw data more meaningful, e.g., by determining relative percentages of each group rather than sheer numbers. Does combat impact suicide? There have been numerous studies of exactly this question, generally indicating that there are not enough differences between and within these groups to identify deployment and combat experiences alone as a predictor of suicide.

It’s notable that combat veterans have a high rate of PTSD (significantly higher than civilians who did not serve in the military, for instance). PTSD, along with its effects— including relational distress, substance abuse, chronic depression, and isolation— are what we identify as risk factors for suicide. So, while deployment status, in and of itself, is not seen as a predictor, combat does appear to play a role in the development of factors that lead to suicide. Ultimately, however, there is no clear indicator of suicide. Make no mistake: valuable insights are gained each year through research. But as too many grieving families know, answers and support can’t come fast enough when it comes to veterans, PTSD, and suicide.

Between 2011 and 2012, suicide rates within the military increased by 15 percent. When Huso’s article shares that unofficial figure from the DoD, it sets the stage for all-too-common criticism of the DoD and associated organizations, like the U.S. Department of Veterans Affairs (VA). There are indeed places where the VA is failing to deliver adequate care, but I would argue that, by and large, the pressure keeps the system accountable. For each story of failure, there are many more unwritten stories of success. Many veterans are getting the help they need and as a result are returning from the brink of suicide, re-engaging life, and thriving post-trauma.

The VA may not be as fully prepared to meet the overwhelming need of all our veterans as we could hope. However, the department is helping many people in significant ways. It has been a frontrunner, for instance, in the fields of PTSD, traumatic brain injury, and prosthetics. The VA houses many of the leading experts in these fields. VA providers have the ability to coach veterans on filing claims, accessing medical treatment, receiving vocational rehabilitation, connecting to housing, and much more. Specially trained VA counselors are now on call 24-7 to aid veterans in crisis. There are more than 1,700 VA locations across the country, including hospitals, community-based outpatient clinics (CBOCs), vet centers, PTSD clinics, community living centers, domiciliaries (for residential rehab and treatment), as well as inpatient and outpatient facilities.

Fortunately, the community is joining the fight in preventing military suicides. Organizations like Give an Hour, Wounded Warrior Project, The Soldier’s Project, Operation I.V., and others are stepping up and working alongside the DoD and VA to support our military men and women. I am encouraged to see Somatic Experiencing® as a very welcome addition to this array of resources.

On the heels of Suicide Prevention Month, I encourage my fellow trauma healers to set a year-long intention to bring our resources to the aid of all those members of the military who have served.

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What else?

Trauma may result from a wide variety of stressors such as accidents, invasive medical procedures, sexual or physical assault, emotional abuse, neglect, war, natural disasters, loss, birth trauma, or the corrosive stressors of ongoing fear and conflict. SE facilitates the completion of self-protective motor responses and the release of thwarted survival energy bound in the body, thus addressing the root cause of trauma symptoms. This is approached by gently guiding clients to develop increasing tolerance for difficult bodily sensations and suppressed emotion.


SE offers a framework to assess where a person is “stuck” in the fight, flight or freeze responses and provides clinical tools to resolve these fixated physiological states. It provides effective skills appropriate to a variety of healing professions including mental health, medicine, physical and occupational therapies, bodywork, addiction treatment, first response, education, and others— Excerpt taken from SETI.

Somatic Experiencing (SE) is a body-oriented approach to the healing of trauma and other stress disorders resulting from multidisciplinary study of stress physiology, psychology, ethology, biology, neuroscience, indigenous healing practices, and medical biophysics, together with over 45 years of successful clinical application. The SE approach releases traumatic shock, which is key to transforming PTSD and the wounds of emotional and early developmental attachment trauma. Trauma may begin as acute stress from a perceived life-threat or as the end product of cumulative stress. Both types of stress can seriously impair a person’s ability to function with resilience and ease. Excerpt taken from SETI

An Embodied approach to healing

Trauma may result from a wide variety of stressors such as accidents, invasive medical procedures, sexual or physical assault, emotional abuse, neglect, war, natural disasters, loss, birth trauma, or the corrosive stressors of ongoing fear and conflict. SE facilitates the completion of self-protective motor responses and the release of thwarted survival energy bound in the body, thus addressing the root cause of trauma symptoms. This is approached by gently guiding clients to develop increasing tolerance for difficult bodily sensations and suppressed emotion.


SE offers a framework to assess where a person is “stuck” in the fight, flight or freeze responses and provides clinical tools to resolve these fixated physiological states. It provides effective skills appropriate to a variety of healing professions including mental health, medicine, physical and occupational therapies, bodywork, addiction treatment, first response, education, and others— Excerpt taken from SETI.

Somatic Experiencing (SE) is a body-oriented approach to the healing of trauma and other stress disorders resulting from multidisciplinary study of stress physiology, psychology, ethology, biology, neuroscience, indigenous healing practices, and medical biophysics, together with over 45 years of successful clinical application. The SE approach releases traumatic shock, which is key to transforming PTSD and the wounds of emotional and early developmental attachment trauma. Trauma may begin as acute stress from a perceived life-threat or as the end product of cumulative stress. Both types of stress can seriously impair a person’s ability to function with resilience and ease. Excerpt taken from SETI

An Embodied approach to healing

Excerpt taken from Sensorimotor Psychotherapy Institute. 

Sensorimotor Psychotherapy (SP) is a complete treatment modality to heal trauma and attachment issues. SP welcomes the body as an integral source of information for processing past experiences relating to upsetting or traumatic events and developmental wounds. SP incorporates the physical and sensory experience, as well as thoughts and emotions, as part of the person’s complete experience of both the trauma itself and the process of healing. Excerpt taken from Sensorimotor Psychotherapy Institute.  


An Embodied approach to healing

SP seeks to restore a person’s ability to process information without being triggered by past experience. SP uses a three-phase treatment approach to gently guide the client through the therapeutic process – Safety and Stabilization, Processing, and Integration. The therapist must pay close attention to the client to ensure that they are not overwhelmed by the process while simultaneously engaging their own abilities and capacities for healing.

It is thought that SP strengthens instinctual capacities for survival and assists clients to re-instate or develop resources which were unavailable or missing at the time the trauma or wounding occurred. Once resources are developed and in place, the traumatic event can be processed with the aid of resources. SP is a well-developed approach with decades of success in the treatment of trauma and developmental wounds. — Excerpt taken from Sensorimotor Psychotherapy Institute. 

Excerpt taken from ACBS Association for Contextual Behavioral Science. 

Dialectical Behavior Therapy (DBT) is a comprehensive multi-diagnostic, modularized behavioral intervention designed to treat individuals with severe mental disorders and out-of-control cognitive, emotional and behavioral patterns. It has been commonly viewed as a treatment for individuals meeting criteria for Borderline Personality Disorder (BPD) with chronic and high-risk suicidality, substance dependence or other disorders. However, over the years, data has emerged demonstrating that DBT is also effective for a wide range of other disorders and problems, most of which are associated with difficulties regulating emotions and associated cognitive and behavioral patterns. 

radical acceptance and change

As the name implies, dialectical philosophy is a critical underpinning of DBT. Dialectics is a method of logic that identifies the contradictions (antithesis) in a person's position (thesis) and overcomes them by finding the synthesis. Additionally, in DBT a client cannot be understood in isolation from his or her environment and the transactions that occur. Rather, the therapist emphasizes the transaction between the person and their environment both in the development and maintenance of any disorders. It is also assumed that there are multiple causes as opposed to a single factor affecting the client. And, DBT uses a framework that balances the treatment strategies of acceptance and change - the central dialectical tension in DBT. Therapists work to enhance the capability (skills) of their client as well as to develop the motivation to change. Maintaining that balance between acceptance and change with clients is crucial for both keeping a client in treatment and ensuring they are making progress towards their goals of creating a life worth living. — Taken from DBT-Linehan Board of Certification. (click to learn more)

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