Trauma Within The Ranks: Fighting Back Against Military Sexual Trauma (MST)

Abstract

According to the most recent statistic from the Department of Defense (DOD) dated April, 2012, females make up roughly 14% of the active duty military population, with service dating back to the Civil War. While it appears ample time has passed for the military to fully integrate and accept women as soldiers, a growing problem has surfaced, namely, military sexual trauma. The story of Molly* will demonstrate the effects of MST, highlight the lack of research that has been conducted on a relatively new diagnosis, as well as resiliency and wellness planning that is particular to such cases.

*Not her real name

Client characteristics

Molly, a 25-year old female active duty E-5 soldier appears quite young until one takes the time to look close enough to notice the early onset of Crow’s feet around her eyes, the creases around her mouth from smoking and the ruddy color around her nose due to broken blood capillaries. The yellowing fingernails have been chewed to nubs, chipping away the façade of youth and showing signs of wear in the armor she has been wearing to protect herself from the constant battle of stress.

The observable signs seen in Molly are common characteristics of an individual who has been experiencing chronic stress and trying to deal with it on their own, without sufficient coping skills. According to the Mayo Clinic, some unhealthy reactions to stress include: physical pain without an outside source of injury; overeating or undereating; explosive anger with little provocation; uncontrollable crying; depression that lasts longer than a bout of sadness; focusing on the negative aspects of life; and a marked increase in smoking or alcohol consumption.

Upon a brief discussion with Molly about her background, it is learned that she identifies as a Catholic (although admits that she has not been to mass in many years), has been serving in the military on active duty for the past six years. She reports being deployed twice to Iraq and once to Afghanistan as part of support units, sometimes being part of the lead crew, which ensures the path is clear of improvised explosive devices (IEDs), returning from her most recent deployment with her unit less than a month ago. Her family appears to be supportive of her career choice, however when it comes to her private life, they are not as supportive. Molly considers herself a lesbian and has been in a couple relationships with other women in the past, although due to the military culture, has had to hide that part of her life from her fellow soldiers. 

Counseling, ordered for Molly by her command due to a recent suicide attempt, is a common occurrence amongst both active duty and veteran military personnel. During the first 155 days of 2012, there were 154 suicides reported involving past or present military members (http://www.politico.com/news/stories/0612/77188.html), a statistic that indicates a 18% increase in suicides from the previous year. However, the difference in Molly’s case is that she is in the office, obtaining the services she needs to aid in the prevention of a successful suicide.

After gaining Molly’s trust and opening an effective therapeutic line of communication, she reveals that she was raped this past tour by a fellow soldier. The attack left Molly bruised, both mentally and physically; feeling powerless as the offender was higher ranking and threatened to keep her on lead caravans, risking her life each time, if she ever reported the incident. The rape also resulted in a pregnancy, causing an increase in mental torment since as a Catholic abortion is considered a sin. 

Molly’s increased alcohol intake and cigarette smoking were ineffective coping mechanisms, leading her to see suicide as the only other option of ending her pain. The shame and guilt associated with sexual attacks is often compounded when one has to rely on their attacker as in a military situation. In a recent study, the incidence of rape amongst female military members perpetrated by their male counterparts was discovered to be 28% (Williams and Bernstein, 2011). 

Military Sexual Trauma (MST) and Posttraumatic Stress Disorder (PTSD)

Molly’s presenting concern is primarily the sexual assault she experienced at the hands of another soldier. Military Sexual Trauma, or MST, is defined by the National Center for PTSD as, “unwelcome sexual attention including gender harassment, unwanted sexual attention, sexual coercion, sexual assault, and rape.” The DOD has reported a 16% increase in MST within military deployments to Iraq and Afghanistan, with many incidents going unreported, as in Molly’s case. The DOD has taken steps to address the growing incidents of MST, one of which was the addition of the Sexual Assault Prevention and Response (SAPR) program, which provides oversight of the DOD sexual assault policy. SAPR’s mission statement, “To enable military readiness by establishing a culture free of sexual assault,” is a good attempt at addressing the issue, but without feeling free to reach out and obtain assistance, some survivors turn to drugs, alcohol or suicide as a way to cope.

Military culture is fraught with power struggles, be it between ranks, warzone conflicts or genders present within the military population. Many, often resulting in more questions than answers, have examined the unique culture of the military but some have produced rather startling findings, some of which are applicable to Molly’s case. The US Air Force was investigated following a rash of sexual assaults in 2003, complete with allegations of assaults and cover-ups, which hit the media causing the ugly truth of sexual assaults within the ranks to become known to the public at large. One study suggests that the power and control concepts contribute to sexual aggression, as new recruits are often devoid of power, causing a possible need for them to seek out other ways they can have obtain control (Callahan, 2009). 

While PTSD has been studied extensively (and still is) amongst the veteran population, MST is a relatively new addition to the trauma spectrum. Rape and sexual trauma is often found to cause more psychological harm than the more common military associated contributing factors to PTSD. The combination of being deployed in a warzone while experiencing sexual trauma can negatively impact the psychological wellbeing of a soldier more than experiencing each incidence separately (Williams and Bernstein, 2011).

Soldiers exhibiting signs of PTSD often come back from deployment with a combination of symptoms, including sleeplessness, nightmares, hostility management issues, flashbacks, panic attacks and a decreased ability to cope within society in a productive manner. Those coming back who have also experienced MST often return with a loss of self-respect, feeling as if they had lost control over their lives and were at a higher risk of self-harm (Benedict, 2007). Molly’s symptoms via self-disclosure during the initial meeting fit those associated with both PTSD and MST. A 2006 study suggests that women with MST had higher rates of PTSD as compared to those who had experienced other forms of trauma (Yaeger, Himmelfarb, Cammack and Mintz, 2006).

Confounding variables and effective coping

The repeal of the Don’t Ask, Don’t Tell (DADT) policy in September of 2011, which in the past had banned openly gay individuals from serving in the military, was a step in the right direction but did not end discrimination. Molly does not feel comfortable sharing the fact that she is a lesbian with her fellow soldiers, partially in fear of retribution or experiencing further trauma at the hands of those she works amongst and relies on for career advancement. The inner turmoil Molly is experiencing as she is caught between an unwanted pregnancy that is the result of a sexual attack and the morals of her religion, which define abortion as a sin, may have compounded her experience of distress, leading her to the suicide attempt. 

As a counselor, one has to separate any personal belief systems to assist the client in gaining a more stable foundation in which they are to rebuild their focus and proceed in life with a stronger and clearer outlook. Instilling a resilience plan and providing tools for the client that are specific to them is key in obtaining a positive and desired outcome. A wellness plan for Molly would need to be holistic in approach to work best, as it would address the biological, psychological, social and spiritual aspects of her presenting concerns (Gladding and Newsome, 2010). 

Providing a safe and secure location for her to share her experience would also be of benefit. Some current therapeutic interventions for MST include cognitive processing and prolonged exposure, with both showing promise as effective measures to help one deal with the traumatic experiences (Cater and Leach, 2011). The Veterans Administration is also conducting trials on new forms of therapy, including guided imagery therapy as a therapeutic adjunct to conventional talk therapy. Sadly, even with these treatment options on the horizon, many will seek out self-medication as effective ways of treating the symptoms, with the rates being higher amongst the military population in which mental toughness is seen as a positive attribute.

Employing effective stress management skills into Molly’s therapy would be an essential step to recovery. These would include an education about the cause of her stress, recognizing the physical and emotional effects of stress, and learn to use appropriate coping mechanisms to current and future stress (Gladding and Newsome, 2010). An ecomap may assist Molly in recognizing her sources of support, outside of the military as well as within. A visual representation of those in her life and their ability to influence, positively and negatively, can serve as a reminder when challenges arise. 

Since Molly’s case is multifaceted, she may need a referral to additional support members, including a physician, drug and alcohol specialists and a counselor who may be more skilled in the Catholic faith, as that aspect combined with her unwanted pregnancy appears to add a significant amount of stress. Having a network in place for referrals helps both the client and the treating counselor.

Advocacy opportunities

Molly’s recovery process may be influenced by several factors, including personal characteristics that may hinder or assist the ability for her to achieve a positive and desired outcome. Some of these include her family not being accepting of her sexual orientation, the unique culture that is found within the military and her religious faith and beliefs. The more recent addition of alcohol use and pregnancy highlight the importance of tailoring a treatment plan specifically for an individual, rather than trying to make the individual fit the plan. 

There are several agencies, both within and outside the military and government that can assist in providing the needed guidance and support to effectively help Molly navigate her path to wellness. The first step of coming into the counselor’s office, by choice or by direct order, is a promising start. By branching out after establishing a trusting atmosphere to explore community resources, Molly will be able to obtain the needed support system that will aid her recovery. Depending on the status of the relationship between her and her immediate family, that may be an avenue to pursue. However, it should be done cautiously, as it may cause more stress to an already precarious situation. 

Upon instilling an effective treatment plan, complete with regular meetings both with Molly and her treatment team, depending on her progress, she may find additional strength in advocating for herself with the assistance of community resources. Within the military, some resources include Service Women’s Action Network, or SWAN which advocates for all military women at the local, state and federal levels to bring about change to create and support legislation that caters to the unique needs of female members of the armed forces. 

With the repeal of Don’t Ask, Don’t Tell, several military bases have started gay and lesbian advocacy groups, such as Gay, Lesbian And Supporting Sailors, or GLASS, and OutServe, which is an association of actively serving military members with 45+ chapters worldwide. Such organizations help to foster a supportive environment, helping to educate military members and spouses about the need to understand and respect others, regardless of their sexual orientation.

Conclusion

The case of Molly is far from rare, as indicated by the statistics on MST within the armed forces. Through education and advocacy, both by survivors and their support system, sexual trauma may come into the light, where it belongs. Only then can it be effectively addressed, both in legislation and in the counselor’s office. By becoming her own advocate, Molly is fostering her own resilience, as seeing a positive outcome from what was despair may help her to continue on the path of recovery. Counselors need to remember that the focus is and should be on the client and helping them to eventually help themselves, leaving any personal ethics aside that may hinder the growth of their client.

*References Available Upon Request