A mission brings purpose; your rank and job provide a place in the hierarchy; your squad provides camaraderie; and shared hardship reinforces that bond More than 1.7 million of the 2.6 million soldiers deployed to Iraq and Afghanistan have transitioned back to civilian life with another one million expected to do so over the next five years (Zoli, Maury, & Fay, 2015). It will likely be many years before revelation of the full psychological impact of these recent military campaigns is made known (Steenkamp & Litz, 2013). Such protracted military engagements, combined with the varying duration of service commitment lengths, make it difficult to discretely identify, track, and compare affected at risk groups (Lineberry & O’connor, 2012) both during the period of service and beyond. Even more problematic, despite the looming uncertainty of future treatment needs, currently available interventions for returning veterans have focused narrowly on extreme psychopathology, and typically only on Posttraumatic Stress Disorder (PTSD).
First what is it? Transition stress encompasses a number of issues facing transitioning military veterans, which can lead to anxiety, depression, and other behavioral difficulties. They include a loss of purpose and sense of identity, difficulties securing employment, conflicted relationships with family and friends, and other general challenges adapting to post-military life. The problems were that this man had gone off to war. It was the most exciting experience he had ever had. Then coming back to a small town where he did not have as much fulfillment, and life seemed kind of dead to him. And that was really the problem he was struggling with: His life had lost its meaning. It was nothing remotely related to the symptoms you see of PTSD. Serving in uniform can provide easy answers to heavy questions. That easy sense of belonging, Bonanno and Mobbs say, doesn’t exist — at least not in clear-cut terms — when a service member leaves the military and return to the lives they left years before.
Second loss of identity may be a root cause. Transition stress is not as simple as missing the adrenaline-fueled highs of war-time service, though that can be a factor. More commonly, it’s a nostalgic longing for that sense of place and self that many within the military felt, regardless of their MOS or theater of operations. “For our generation of veterans, for us being an all-volunteer force, we all go in during a period of emerging adulthood,” Mobbs told Task ; Purpose. “We’re typically asking ourselves the existential questions: Who am I? What do I want to do? What’s the meaning of life? And the military provides a really ready answer for that. They tell you: You have purpose. What you’re doing is meaningful. You matter.”
The questions don’t stop when you get out, but the answers do. “The military gives you all of these really concrete answers that are very appealing in a variety of ways, and that becomes such a salient part of your identity,” Mobbs said. “And then when you take that all away… how do you reconcile that discrepancy? “The disconnect between war and “The World” isn’t new territory, of course. In a 2010 article for Vanity Fair, author Sebastian Junger observed that recent veterans “return from wars that are safer than those their fathers and grandfathers fought, and yet far greater numbers of them wind up alienated and depressed. This is true even for people who didn’t experience combat. In other words, the problem doesn’t seem to be trauma on the battlefield so much as re-entry into society.”.” Veterans of military service may rely heavily on nostalgic memories of their service experiences as a means of controlling or counteracting civilian transition struggles. As previously stated, a majority of veteran’s desire to return to service and many possess general regrets about leaving the military (Zoli et al., 2015Nostalgia as defined by Sedikides, Wildschut, & Baden, 2004, suggests a multifaceted emotional experience in which the self is the primary protagonist in a sentimental longing for the past by which people promote and cultivate virtuous aspects of the self (Wildschut, Sedikides, Arndt, & Routledge, 2006)
We over-invest in making soldiers, airmen, sailors, and Marines. We under-invest in transitioning veterans. “We spend millions of dollars and weeks and months indoctrinating and transforming civilians into service members, and they spend their entire enlistment or contract having all those behaviors reinforced, through training, or deployments, or any number of things. And then you transition out,” Mobbs said. Often, leaving the military involves attending a short transition assistance class that focuses on things like how to write a resume and what to wear to a job interview. “You sit in a classroom for a week and you check a box,” then grab your DD 214, and hit the road, Mobbs said. “By the time you transition out, it’s too late. The horse has already left the barn.”
Relatedly, stereotype threat, the risk of confirming a negative stereotype about one’s group (Steele ; Aronson, 1995), is more likely to arise and produce potentially inhibiting effects when the individual is highly identified with the group to which the negative stereotype applies (Schmader, 2002). The media has tended to represent veterans of recent wars as predominantly either broken warriors or unhinged and armed. It is not uncommon for example to view headlines such as “Police get help with vets who are ticking bombs” (USA TODAY), “Experts: Vets’ PTSD, violence a growing problem” (CNN), and “Veteran charged with homeless murders: Hint of larger problem for US military?” (Christian Science Monitor) (Hoit, 2012). Given such sensationalized press, it seems unlikely that the average American possesses an accurate understanding of the veteran experience. Complimentarily it is likely that many service members with mental health challenges may not seek out mental health services for fear of confirming these unsavory stereotypes.The sensationalized image of veterans struggling to reintegrate has roots in the post-Vietnam era, when veteran organizations advocated for wider recognition of the psychological toll of war (Phillips, 2015). Unfortunately, a more nuanced approach has not been adopted in the wake of increased sympathy towards veteran struggles. A considerable theoretical and research enterprise has developed to examine the role of stereotype threat within schools and workplaces (see Croizet and Claire, 1998, Nguyen and Ryan, 2008, Spencer et al., 1999, Steele, 1997). Adopting a similar program of research on veterans’ experience would provide critical information about an under-explored, non-pathological piece of the veteran transition.
The various transition factors we’ve reviewed above suggest an obvious imperative for a broader clinical and research agenda regarding veteran psychological health. In this final section, we consider what such a framework might look like and offer suggestions about how the field might move forward. To begin with, there is a clear need for greater study and understanding of the heterogeneity in veteran mental health outcomes. In making this point, we want to be perfectly clear that we are in no way discounting the immense difficulties that veterans with PTSD might face. By the same token, however, we would argue that work with traumatized veterans is impeded when the distinction between PTSD-related symptoms and other broader transition difficulties and stressors is blurred. Accepting that there is no panacea, we argue that it is only when these heterogeneous difficulties are better understood that we will be able to develop a suitable repertoire of interventions that can appropriately target relevant symptomatology or help protect against the deleterious areas of the transition.
Up to the present, the bulk of research and theory on Veteran populations has focused primarily on correlates of psychopathology with little emphasis on other factors (Brewin et al., 2000, Ozer et al., 2003, Schultz et al., 2014). The data on predictors in prospective military-to-Veteran studies has been limited largely to the most basic demographic or situational factors with only occasional attention to psychological variables (e.g., Berntsen et al., 2012, Bonanno et al., 2012: Engelhard et al., 2007). This narrow focus is contrasted by the broader thrust in civilian stress and trauma research on the range of psychological mechanisms that moderate between multi-faceted stressors and outcomes has helped to illuminate both resilient adaptation and dysfunctional patterns of post-adversity adjustment (Bonanno, 2004, Bonanno et al., 2007, Bonanno et al., 2010, Galatzer-Levy and Bryant, 2013). It is imperative, as the sobering failures in veteran mental health treatments would suggest, that research on veterans in transition adopt a similarly broad perspective.
An ideal research design to begin understanding this complex, multifaceted experience should whenever possible encompass prospective data collection beginning at entry level basic training and continuing while soldiers are in active duty and then repeatedly after they complete their military service. Such a design is entirely feasible as a number of studies have already utilized a similar approach (e.g., Berntsen et al., 2012, Engelhard et al., 2007, Smith et al., 2008). The Army Study to Assess Risk and Resilience in service members (Army STARRS) is currently using this approach to address suicide and increase knowledge about risk and resilience factors for suicidality and its psychopathological correlates (Schoenbaum et al., 2014). What has not been done however is the inclusion of robust prospective measurements that capture how soldiers and later Veterans experience these periods, their values, roles, expectations, stresses and strains. Such a design would also make it possible to tap into soldier’s psychological strengths and deficits, such as their ability to regulate emotional (Gross and Thompson, 2007, Mennin et al., 2007) and cognitive processes (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008), take advantage of social resources to buffer stress and effort (Coan and Sbarra, 2015, Coan et al., 2006), and flexibly modify their behavior across different situational demands (Bonanno and Burton, 2013, Kashdan and Rottenberg, 2010). A prospective design would also allow for a fuller understanding of the complex aspects of the transition stressors, including the various domains reviewed in this paper, how these stressors might vary or interact across individuals and how they might be moderated or exacerbated by individual strengths and deficits. With such data it would be possible for example to measure soldiers’ experience of training and then active duty, as well as their psychological strengths and deficits, and then to utilize this information in the service of predicting their future outcomes as well as how interventions and supports might best facilitate soldiers as they make the key transition back to civilian life.
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There is a great deal yet to understand. As we have attempted to show, the transition into and then back out of military life is complex and multifaceted. Soldiers and veterans are undeniably resilient, both by selection and by training. But they are not superhuman. The process of transitioning and reintegrating back to civilian life is often stressful and can generate lasting psychological difficulties. Our intention was not to fully explain soldier-to-civilian transition stress largely because an adequate conceptual framework for understanding this type of stress does not yet exist. Rather, we attempt to review theoretically and empirically relevant aspects of human behavior that could be justifiably mapped onto the soldier-to-civilian transition in the hopes of stimulating new research in this area. We have by no means covered all possible sources of that stress, and we have only sketched how research and theory in this area might move forward. However, we emphasize that the failure to appreciate the collective complexity of the transition into and out of the military, in addition the caustic influence of PTSD, would only perpetuate the misunderstanding and ongoing stagnation surrounding current veteran treatment. It is our hope that the current article will push the study and understanding of veterans’ experiences beyond its current narrow focus on PTSD, and foster new research, new understanding, and new ideas about how to best intervene and support veterans of all generations.
We know very little about the prevalence of transition stress, because it hasn’t been studied. Vets affected by transition stress are “just simply struggling, and they’re struggling with a variety of issues,” Bonanno told Task ; Purpose. Though the essay suggested that post-9/11 veterans faced higher levels of stress when they left the military than their forebears, a lack of research into these stressors makes it hard to know for sure if this problem is growing more severe, or if it’s always been there. “We don’t really know… the extent that it’s new, or a characteristic of GWOT veterans,” Bonanno said.
