Handbook of Counseling Military Couples

Bret A. Moore

• Publisher: Routledge
• Year: 2012
• eBook ISBN: 9781136850271
• Topic: Psicología
• Subtopic: Salud mental en psicología

The military imposes unique and often severe challenges to couples, which clinicians – particularly the growing numbers of civilian clinicians who see military couples – often struggle to address. These problems are only compounded by misunderstandings and misconceptions about what it means to be part of a specific branch of the military and part of the military as a whole. Handbook of Counseling Military Couples includes a clear, thorough introduction to military culture and to couple relationships in the military. But more than that, it provides readers with expert analyses of the special types of issues that come up for military couples and shows clinicians how to address them productively. In the chapters, readers will find the answers to questions such as how are military couples' rights different from those of civilians? What attitudes and beliefs about relationships might military members bring to a session, and how are those different from those of civilians? What is the state of marriage and divorce in each of the branches and within the military in general? For a particular treatment modality, how does research in with military members compare to that of civilians? When should particular treatment strategies be used, and why – and how?

1

Introduction to Counseling Military Couples

BRET A. MOORE

A great deal of attention has been given to the psychological and social hardships the men and women of the Armed Forces have endured since 2001. Thankfully and rightfully so, countless biopsychosocial issues that affect the individual service member have been covered in premier scientific journals, comprehensive authored and edited books, and all forms of popular media. In addition to the individual service member, the military family unit has garnered considerable interest, particularly with regard to issues of resiliency, growth, and overall functioning.

One area of military mental health that has been less studied and written about is the impact the military lifestyle has on the military couple. Whether it is long and back-to-back combat deployments, uncertainty about career trajectory, frequent moves, or frequent school changes for the military child, the impact on the military couple can be tremendous. This is in addition to the same stressors all couples face, such as finances, incompatible personality characteristics, loss of intimacy, infidelity, and more.

Some may argue that as the current conflicts in Iraq and Afghanistan wind down and eventually come to a close, the strain on military couples will decrease. Although this is true to an extent, the residual effects of over a decade of fighting two wars will reverberate in military couples for many years. How could it not considering that tens of thousands, if not hundreds of thousands, of service members are suffering from posttraumatic stress disorder (PTSD), depression, substance abuse and dependence, chronic pain, traumatic brain injury, and other psychiatric and physical disorders?

The focus of this book is the myriad relationship issues that many military couples battle on a daily basis. As noted, in addition to dealing with the same problems all couples endure, military couples face unique challenges. Consequently, it is important for the clinician working with military couples to appreciate these differences and understand them within a military context. This volume addresses this need.

Chapter 2, by Michael R. DeVries, H. Kent Hughes, Harvey Watson, and Bret A. Moore, begins Section 1 on military culture. This chapter addresses the unique aspects of the military culture that are important for clinicians treating military couples to understand. The experience of this group of authors includes special operations work, multiple combat deployments, and direct line command of combat troops. Topics such as rank, military hierarchy, spirituality, personality characteristics, and the “mission first” mentality are covered in detail.

Chapter 3, by Lyndon A. Riviere, Julie C. Merrill, Jeffrey L. Thomas, Joshua E. Wilk, and Paul D. Bliese, presents a study that reports the latest findings on marital functioning in the military. First, it examines 2003–2009 trends in three self-reported marital functioning indicators to investigate whether the percentage of soldiers reporting high marital quality has declined over the course of simultaneous combat operations in Iraq and Afghanistan and whether reports of infidelity and separation/divorce intent have increased over time. Second, it examines whether these marital functioning trends are reflected in soldier marital dissolution rates between 2003 and 2009. Last, the authors interpret their findings with both the trauma and stress hypotheses.

Robert P. O’Brien’s Chapter 4 on cognitive-behavioral therapy for couples begins Section 2 on treatment approaches. This chapter details the most commonly used treatment approach in working with couples. The most current research is covered as well as the strengths and limitations of using this approach with military couples.

In Chapter 5, Rebecca Tews-Kozlowski, outlines the solution-focused model for couples treatment. Arguably the most suited treatment for military couples due to its pragmatic approach to solving problems, this chapter presents a well-written account of how the model can be applied to military couples, particulary by staying in the present, focusing on assets and strengths, and working on attainable goals.

Kathryn D. Rheem, Scott R. Woolley, and Neil Weissman cover the utility of emotionally focused couples therapy with military couples in Chapter 6. Outlining the main goals of this approach, expanding and reorganizing key emotional responses, creating a shift in partners’ interactional positions, and fostering the creation of a secure bond between partners, the authors present a nicely written case vignette, which highlights the ease of use of the approach.

No other treatment for couples has seen such a recent increase in interest and research as the one presented in Chapter 7. Robert P. O’Brien details the Gottman method couples therapy model of treatment and how it is already being used with military couples. With the primary goals of increasing respect, affection, and closeness, breaking through conflict when feeling stuck, developing a better understanding of each other, and keeping conflicts civil and calm, O’Brien discusses many of the benefits as well as the limitations of this approach with military couples.

Chapter 8 opens Section 3, which addresses the most common and unique challenges facing military couples. In this chapter, Lynn K. Hall provides a broad and comprehensive review of how the military culture has an impact on the relationship. Specifically, she discusses the challenges of role ambiguity, deployment, childhood attachment, and stigma. This chapter is an excellent complement to Chapter 2.

The remaining 9 chapters in Section 3 cover the following topics: separation and divorce (Chapter 9, Walter R. Schumm, R. Roudi Nazarinia Roy, and Vance Theodore); PTSD (Chapter 10, Jason M. Lavender and Judith A. Lyons); depression (Chapter 11, Kevin M. Connolly and Kathryn S. Hahn); infidelity (Chapter 12, Douglas K. Snyder, Christina Balderrama-Durbin, Caitlin Fissette, David M. Scheider, J. Kelly Barnett, and Samuel Fiala); intimate partner violence (Chapter 13, Nicole D. Pukay-Martin and Patrick S. Calhoun); substance misuse (Chapter 14, Sharon Morgillo Freeman); traumatic brain injury (Chapter 15, Carrie-Ann Strong and Jacobus Donders); enhancing resilience with culturally competent treatment of same-sex military couples (Chapter 16, Matthew Porter and Veronica Gutierrez); and cultural differences (Chapter 17, Rebecca Tews-Kozlowski and Desireé King).

In Chapter 18, Mathew B. Tully, a former military lawyer, provides invaluable information about divorce for those military couples who decide that this is the most appropriate solution to their situation. And finally, in Chapter 19, Walter Penk, a four-decade veteran clinician and researcher of the Veterans Administration, Dolores Little, and Nathan Ainspan outline the most useful and tested military and civilian psychosocial rehabilitation programs for couples dealing with PTSD.

Section 1

Military Culture

2

Understanding the Military Culture

MICHAEL R. DEVRIES, H. KENT HUGHES, HARVEY WATSON, and BRET A. MOORE

INTRODUCTION

At an annual formal military ball, speaking to service members, their spouses, and significant others, Distinguished Service Cross recipient Chief Warrant Officer Dave Cooper made the point clear: “The Army recruits Soldiers, but it re-enlists families.” In other words, service members serve only as long as their spouses allow them to serve. Service members enlist for a defined number of years. When it comes time to decide if a service member will reenlist, it is highly unlikely that he or she will do so if his or her spouse is unhappy with the military lifestyle.

It is a well-known truism when working with military families that the most significant threat to a service member’s effectiveness is family problems. The moment a couple is divided or suffers significant marital discord, the service member’s effectiveness is compromised. A troubling example is the increase of suicides in the military. It has been well covered in the media that the suicide rate in the military has risen significantly in the last few years. The investigations of recent suicide attempts and completed suicides show a common theme of marital/relationship distress. From 2005 to 2009, relationship problems were a factor in over 50% of the suicides in the Army (Analysis of Army Suicides, 2009). The health of our military fighting force is directly related to the health of our military marriages. What we see in the military is a common drama of relationship problems played out in an environment of uncommon stressors.

To begin the discussion of treatment approaches for working with military couples, it is important to discuss military culture and how military families may differ from their civilian counterparts. This chapter provides an overview of the unique characteristics of service members and their families as well as the overall military organization and how a clear understanding of the military culture is relevant to clinical practice.

MILITARY CULTURE

As we discuss the culture of the military and how clinicians can understand the unique pressures military service places on relationships, we must be cautious not to create a simplistic description of the military culture and therefore the military marriage. The military is not a collection of homogeneous individuals and couples. Consequently, individual couples vary in how much their marriage resembles the prototypical military marriage. This variation is due to many factors commonly discussed in marital counseling literature that would be true of any couple, civilian or military. In addition to these factors that all marriages have in common, there are characteristics specific to the military and the wide variety of subcultures within the military that may affect martial relationships. Despite the variation across the military, the unifying factor that makes a discussion of the military marriage worthwhile is the similarities that exist between the individual cultures of the Armed Forces that are collectively very different from civilian culture. Our primary experience has been with the Army, so our perspective will undoubtedly reflect this experience. We have tried to avoid making the discussion specific to the Army as much as possible (see Christian, Stivers, & Sammons, 2009; Matthews, 2009, for further discussion of military culture).

In considering the military couple who presents for counseling, like any initial counseling session, one must assess the effects of each individual’s culture on the marriage. This requires an understanding of the cultures of both the individuals and their degree of acculturation. As with any culture, two individuals may be a part of the same military culture, but they may identify with the culture to differing degrees.

A common misconception is that all soldiers are the same. For example, while people who are not associated with the military may intellectually know there are many different jobs in the military, they often do not truly appreciate the various roles service members play and skills they possess. This misconception likely comes from the representations of military service in the media. Whether it be the news media or Hollywood, it is rare to hear about soldiers who are supply clerks, mechanics, dental assistants, water purification specialists, and sheet metal workers. The media either portray an infantry soldier, face to face with the enemy, locked in mortal combat, or show the pilot flying an aircraft in dramatic dogfights with the enemy air force. Combat units such as Special Operations, infantry, armor, and aviation are often called the “tip of the spear.” While these individuals are the most lethal and well-known personnel of the military, they would not be much without the rest of the spear. The reality is that the vast majority of service members are support personnel. While there are commonalities among the different military occupational groups, there are also significant differences.

Even when we consider different combat arms roles, one can see significant differences in culture. The Special Operations, aviation, and infantry soldiers may have much in common with each other when compared to those in more supportive roles, but there are significant differences between these communities as well. In addition, many service members in supportive roles may be similar in personality style to their combat arms peers. By way of illustration of the variation in culture within the military, we use Army Special Operations as an example. Service members in Special Operations typically are volunteers from all other branches of the Army. It is likely then that some of their peers in these branches may have very similar personalities and cultural experiences; however, they did not volunteer. Special Operations service members are often called triple volunteers because they volunteer for the Army, volunteer again to jump from airplanes, and volunteer a third time to serve in a special unit. In addition to rigorous training, Special Operations organizations have strict and highly selective assessment programs. What characteristics may lead them to volunteer for and be able to complete this specialized training? Matthews (2009) discussed the differences in character traits between West Point cadets who complete their basic training and those who drop out. Special Operations assessment programs select for certain traits and therefore create new environments with certain characteristics based on their missions. By nature of being smaller and more specialized, these units develop their own cultural norms, not the least of which is pride in being willing to volunteer more times than the average service member.

Another good illustration of differences in cultures that may look superficially similar is that of aviators across all branches of the military. We often refer to the personality of the pilot because there seems to be commonalities between aviators; however, aviators in the Army may show significant cultural differences from their peers in the Air Force and Navy. For both the Air Force and Navy, pilots are officers who attended college before becoming pilots. In the Army, the majority of pilots are warrant officers. Warrant officers are technical experts who are often drawn from the enlisted ranks or come from direct accession programs (so-called high school to flight school). Many times, Army pilots may have served in the infantry or othe...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Dedication
• Contents
• Series Editor’s Foreword
• Contributors
• Acknowledgments
• 1 Introduction to Counseling Military Couples
• Section 1 Military Culture
• Section 2 Treatment Modalities
• Section 3 Specific Issues in Military Relationships
• Section 4 Resources
• Index