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Active Listening for Moms and Friends

Q: Dear Frank,

This question comes from a member of the Army Moms group.

My son got home today from Afghanistan. I cried and shook as I hugged him. I fell light a huge weight has been lifted. I think I have been holding my breath for the last year. It has been a wonderful day and I thank God he is home safe and sound. He is a little quiet and says he has seen some really bad stuff. I'm not sure how to handle this. I'm just trying to give him time but the mom in me wants to get him to tell me so I can lighten his load. He says I don't want to know. How do you guys handle this? I really need some good advice.

A: Dear Mom of a young Service Member,

We're all in this together and it is good to realize that we have a large family of parents, friends, advocates, therapists, clergy, and others who care. When your son says to you, "You don't want to know," I assume he is looking out for you. He wants to spare you the images and the sounds and the smell of the place. I'd thank him for that. It is considerate of him. And it doesn't mean he thinks you are fragile. Many of my patients, including those who know that I have heard hundreds and hundreds of trauma stories, try to spare my feelings. They don't want me to hurt for them, and they don't want to spread the horror that they have witnessed. When it feels appropriate, I might explain that I have learned how to listen without becoming damaged. But it's a fine line. I can't say I'm unaffected. I don't want to suggest that these experiences are less profound and terrible than they really are. So step one, I'd suggest, is to express gratitude for his kindness and caring.

It is good for your son to have a person who can hear him out, a buddy or an older person who understands. Odds are he already has such a person in his life. You'll feel reassured if you know that this relationship exists, and is being used appropriately. He may be willing to let you know. I'm very interested in the natural friendship network of my patients, and I do try to nurture good, supportive connections. Not too long ago, I had two Marines come for sessions together. One was married, the other wasn't. There was a strong bond between the two. They let it all out in front of each other and in front of me. They kept most of this away from their closest family members --certainly their Moms. One had a military Dad and there was some sharing with him, but not all the detail.

We have good evidence to suggest that Service Members who have "seen some really bad stuff," as your son reports, do best when they use normal networks to sort out their feelings. There is no need to think about mental heath professionals until and unless serious signs emerge.

These serious signs include nightmares and flashbacks persisting at least a month. They include serious drinking and drugging. They include shutting down and walling off from others so that family life and school or work are imperiled. They include shifts in character to an alarming extent, including dangerous outbursts of anger. Usually, this state of affairs can be avoided through peer support and healthy activity. But exposure to deadly conflict can produce PTSD, depression and substance abuse. So learning about those conditions is useful, for you, Mom.

Here is a page I have helped create: http://www.giftfromwithin.org/html/military-family-resources.html There are many, many more. Just go to Google, put PTSD Info in the subject line and have look. Sharing insights and concerns with others in the military support network is useful, too.

If your son does change his mind and chooses to tell you about his "bad stuff," listen actively. Don't interrupt and don't rush to reassure and comfort too quickly. Here's a good link on "active listening":
http://www.linus-geisler.de/dp/dp04_listening.html

It isn't easy to picture your son in harms way, or to realize that he may have been involved in lethal activity that causes him feelings of guilt and grief. I try not to say, "You have no reason to feel guilty," or words to that effect. I might say, "Feeling guilty is the burden of having a good character, a conscience."

After some painful memories are shared, it helps to move to other topics. But never too abruptly, giving the impression that you have heard enough and want to close him down. It's best for him to set the pace and the duration. It's best not to interrupt. In a therapy session, I have to establish a time limit. So I do change the subject well before the end of the hour. I ask about exercise or friends or family. I lighten the subject, but keep it relevant. You could do that, too, if the time together must end soon.

Everyone is different, so there are few hard and fast recommendations. You do want your son to feel comfortable being with you, knowing you love him, and trusting that you will honor his private experience of profound reality. You'll know you are on target when he tells you, little by little, what he wants you to know. You'll know you are on the right track when the two of you have fun together. You'll know all is well as you see him move through those stages of transformation into adult life, with an occupation, a family, and friends who care.

Frank M Ochberg, MD

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