Military Spouses often describe feeling invisible. While the military works hard to educate service members in recognizing depression and other mental health symptoms in themselves, there is a disconnect when it comes to the whole family. In fact, during pre-deployment and reintegration training offered to military spouses, we spouses get educated on how to recognize these same symptoms in our service members and are given a small list of resources to use if we ever need to sound the alarm or seek guidance for our loved one. But what about us? Who is watching us?
As a veteran, current military spouse, and a clinical social worker, I have counseled service members and spouses regularly since 2009. While interning at the Warrior Transition Battalion on Joint Base Lewis McChord, it was common practice when working with a service member to ask their spouse, “What changes have you noticed?” in regard to their spouse. The service member was our focus; either getting that soldier back to full duty or medically discharged. We rarely asked the spouse “How are you doing?” Our focus on the service member supported the overall mission of the military, but failed the family. Had you asked me at the time, however, I thought I was servicing the whole family. I think if you had asked any practitioner at that time, they would have confidently said the same thing, that our mission is serving the whole family; while very much focusing our service on the one in uniform.
In 1999, Christopher Chabris and Daniel Simons created a famous experiment called “The invisible gorilla” which tested selective attention by having viewers count how many times a basketball is passed between players wearing white shirts surrounded by other players wearing black shirts. In the middle of the exercise, a woman in a gorilla costume walks through the scene, beats her chest and walks out. 50 percent of the time, viewers failed to see the gorilla.
Naturally, we do want to focus on our service members. Almost 2 decades at war has wreaked havoc on their bodies, minds and spirits. The operations tempo and low enlistment numbers results in the same service members being sent on back-to-back deployments. Yes, we do need to focus on our service members, but does this create inattentional blindness in health providers to the spouses and children of service members who are also suffering the effects of military life?
Are providers missing the gorilla?
We learned from our Vietnam Era Veterans that more focus needs to be on service members’ mental health. Since then, amazing strides have been made around issues like Post Traumatic Stress (PTS), Traumatic Brain Injury (TBI), and moral injury. Yet with the focus so heavily on compensating for the failures in support of our veterans in the past, are we creating bias and limitations in health and service providers? Regarding the findings in the invisible gorilla study, Daniel Simons says “Our intuition is that we will notice something that’s that visible, that’s that distinctive, and that intuition is consistently wrong.” So as providers, our intuition tells us we will see the visible and distinctive spouse, walking into the room, sometimes beating on their chest in frustration, or quietly sitting in a chair next to their service member, but do we? Do we really see them?
Military leaders and service providers continue to look at the service member as the client and reserve the spouse as supplemental support or collaboration for servicing their client. Our children go completely unnoticed. This is an example of inattentional blindness. Because our attentional, cognitive, and processing resources are limited, we dedicate what matters most based on our social and cultural experiences. Experiences that then impact our training to treat a hierarchy of needs in order of severity and importance. We are conditioned through awareness campaigns like the 22PushupChallenge to prioritize our service members because the severity of missing something with them is costly. The suicide rate among veterans and service members is drastically higher than the civilian population and has also increased since the Covid-19 epidemic. Even with the rise in awareness, it is still not enough.
Without diminishing the needs for our service members, we need to also address the needs of their families. What is less studied is the suicide rate of military family members. While the Defense Suicide Prevention Office recently released their second study on these numbers, there are limitations in accurate numbers based on death certificate reporting. In my extensive interviews with military spouses, a recurring theme is of military spouses who reached out to a therapist. During the first session, the therapist responded in a way that made the spouse feel invalidated, or made the spouse lose trust in the therapist’s ability to fully understand their needs and lives. Invalidating statements like “Well you kinda knew what you were getting into when you got married, right?” or statements like “Wow, I had no idea we still had service members in Afghanistan. How do you do it?” We do want to allow our clients to be the professional of their lives and experiences, but trust is exceptionally hard to come by in this population.
As service providers working with military families, it is our ethical duty to be culturally competent and informed of best practices working with this population. The 2019 Blue Star Families Military Family Lifestyle Survey shows military spouse, veteran, and veteran spouse respondents report a higher prevalence of mental health challenges than the broader U.S. population. If you are a provider, please consider accepting TRICARE insurance so our families can have more options in providers. We need you. We also need you to seek supervision when appropriate, to take some of your continuing education units (CEUs) in subjects that help advance your knowledge working with military families, and connect with other organizations offering services to this population so you have a large resource to refer to these families if the needs arise.
If you are a military leader, service provider, or any organization supporting military families, I think it would benefit us all to continually challenge ourselves by asking, “Am I missing the gorilla?”