Psychotherapy
as Soul Work
 

February
Soldier's Heart: The Soul's Protest.


…but who is it now, in my ears, who hears my voice?
Who says words with my mouth? Who looks out with my eyes?
What is the soul? I can not stop asking…Rumi

James Hillman tells us that the languages of many so called “primitive” people have “…elaborate concepts about animated principles which ethnologists have translated as ‘soul.” Many of these peoples also recognize a condition we could call “loss of soul”, where a person is out of him or her self and can not find the connections to others. Better than anything detailed in our modern diagnostic manuals, this describes the loneliness, despair, addiction and loss of meaning that I encounter each day in my psychotherapy office.

Of course, the “psyche” of psychotherapy derives from the Greek word referring to breath, soul and life, and “therapy” from the word meaning to “minister, serve and attend to.” While we may never answer the question, “What is the soul?“, we know, as Tomas Moore wrote, that soul “…is tied to life in all of its particulars -- good food, satisfying conversation, genuine friends, and experiences that stay in the memory and touch the heart”

What does it really mean for a psychotherapist to minister to the soul? A person is usually driven to psychotherapy by painful symptoms, hoping to quickly eradicate these symptoms and become a happier, more well-adjusted person. However, Hillman warns us that “because symptoms lead to soul, the cure of symptoms may also cure away soul, get rid of just what is beginning to show, at first tortured and crying for help, comfort and love, but which is the soul…trying to make itself heard…for the symptom is the first herald of an awakening psyche that will not tolerate any more abuse.”

A practitioner of “soul” psychotherapy attends to symptoms and helps decipher the soul’s message, not just for the individual, but for the collective. The soul, that spark of awareness that “looks out through my eyes”, belongs to a larger, world soul. Let’s apply this approach to the following “case studies.”

According to an article in the January 17 San Francisco Chronicle, 30% of the soldiers returning from Iraq may need psychiatric care, to deal symptoms of anxiety, panic, depression, anger, nightmares, estrangement from loved ones, emotional numbness and a variety of somatic complaints. The article quoted Veteran’s Affairs workers concerned about adequate funding for such treatment. Certainly, we, as a nation, have a responsibility to provide the best medical and mental health care for veterans returning from war. But I think we owe them far more that that.

If we really listen to what their symptoms are telling us, we hear the cry of our collective soul. As the Chronicle article points out, psychological wounds of war have been chronicled since ancient times, given names such as “Soldier’s Heart,” during the Civil War, “Battle Fatigue,” in World War II, and, since Vietnam, “Post-Traumatic Stress Disorder.” In this progression we see both the ascendancy of the psychiatric paradigm and the power of language. Psychiatry’s ability to name a human state as a “Disorder” gives its practitioners awesome power. It defines a collective catastrophe as an individual malady.

It is not a far stretch of imagination to feel the impact of being in a war zone such as Iraq, in near constant peril, unable to tell friend from foe, witnessing death and suffering. What would a “normal” reaction be? What we label as a “Disorder” might be the natural human response to inhuman conditions. It may be that those who do not develop observable symptoms are in greater psychological peril. What about the barely perceptible damage done to the soul of the society that sent them and those of us privileged to distance ourselves from the trauma?

What the Chronicle article does not mention is the high incidence of suicide. A Dayton Daily News examination, published in October 2004, identified 21 returning soldiers who committed suicide, although the actual number is likely much higher. In several of the cases, family members say that the horrific experience of war contributed the deaths. Even more soldiers have committed suicide while still in Iraq. That so many would chose suicide, the permanent solution to a temporary problem, shows how unbearable the emotional wound of war can be.

Some of these suicides give us a window into a rarely discussed psychological impact of war. Killing other people is itself traumatic, especially when the killing violates the soldier’s moral values. Like in Vietnam, American soldiers in Iraq cannot easily distinguish “enemy combatant” from civilian, ally from adversary, causing them to sometimes shoot first and question later. Internally, this questioning can go on for years and cause severe spiritual and emotional distress. Even if commanded to take part in an atrocity, the guilt can be overwhelming.

Jeffrey Lucey, a 21 year-old reservist from Belchertown, Massachusetts, returned from Iraq and descended into depression, alcohol abuse, and hallucinations. After two admissions and discharges from a VA psychiatric hospital, he hung himself in his parents’ basement, pictures of his Marine unit on the floor below him. Shortly before his death, he had shouted at his sister, "Don't you understand?" Your brother is a murderer." He then showed the dog tags he said that he took off the necks of the two Iraqi soldiers he was forced to shoot, one in the eye, the other in the back of the neck.

In perhaps the most dramatic “case,” Andres Raya, a decorated US Marine of Mexican decent, came home from Fallujah for the holidays and brought the war to his hometown of Ceres, California, making casualties of himself and two local police officers (one dead, one wounded). "It was premeditated, planned, an ambush," according to Ceres Police Chief Art de Werk, "It was a suicide by cop." De Werk said “investigators …believe that Raya, a Marine who had served seven months in Iraq, was concerned about the possibility of going back into combat.” Julia Cortez Raya said that her son served in Fallujah: "He came back different.” While we can only speculate about what drove Raya to kill and be killed, we know that the assault on Fallujah was particularly bloody, with many civilian casualties. Participation in such an event could certainly change someone profoundly.

There is no justification for Mr. Raya’s horrific actions. To understand is not to condone. To look for the soul’s message in the symptoms, no matter how severe, is not to diminish the suffering of the victims of his assault, who were decent men doing their jobs. Perhaps the soul’s message can be found simply in the fact that Mr. Raya brought the war and its suffering home, to his home town, so that we could not so comfortably avoid it. Perhaps the soul is telling us that home is where the real problem lives and the real enemy resides. Psychotherapists are always urging clients to look inside to find the source of their troubles. Couldn’t we say the same to our nation?

Many of my comrades would chasten me for being “political.” Psychotherapy has always been political. Although many therapists consider themselves liberals, the history or our profession has been far from progressive. It was not until 1973, under pressure from gay rights groups, that we finally removed homosexuality from our list of psychiatric disorders. Psychotherapists still sometimes argue that white people, who date or marry outside their race, are suffering from low self-esteem. Black men are still misdiagnosed on a regular basis, being much more likely to be labeled “paranoid” than their white counterparts. To define a social problem as an individual pathology is a political act and psychotherapists do it every day.

Certainly, it could be true that some troubled veterans are mentally ill, and were so before entering the service. Others may have had an underlying psychiatric condition that war experiences exacerbated. To refuse to explore beyond the boundaries of individual psychopathology is gross negligence. Supporting our troops takes a lot more than bumper stickers, flag decals and yellow ribbons. We need to listen to what they say, and, equally importantly, what their symptoms say. Not only must we listen, we must take the message into our hearts, to see them as part of us and not separate.

I am not suggesting that waging war is never justified or necessary. That is for all of us, as citizens, to decide. As psychotherapists, our job is to help our clients gain awareness of their motivations, and clearly understand the consequences of their actions. Often, we must break through walls of denial. If, as a nation, we choose to send our soldiers into war, let’s be honest about how the trauma impacts them, and above all, let’s not blame them for their suffering

©2005, Gary Hoeber

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Psychology has a long past, but only a short history. - Hermann Ebbinghaus

Gary Hoeber has been working as a psychotherapist since 1976, helping a broad range of people successfully deal with a wide variety of life challenges. He is a leading practitioner and teacher of group psychotherapy. An Instructor at John F. Kennedy University since 1988, he offers classes on "The Practice of Group Psychotherapy." His approach to group therapy is highly interpersonal, assisting in the development of effective communication and relationship skills and increasing the capacity for intimacy, friendship and community. His work with individuals focuses less on pathology, and more on the unfolding of one's life purpose, using a depth psychology informed by poetry, story and mythology. Gary is licensed as a Marriage and Family Therapist and has offices in Berkeley and San Rafael, California. garyhoeber.com or gmhoeber@comcast.net. Gary will also be reviewing important new books on psychotherap



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