Putting the Rucksack Down: One Military Psychologist’s Story of Vicarious Trauma and Resilience

A photo of soldiers legs dressed in fatigues and their bags on the floor.
U.S. Air Force photo by Senior Airman Victoria H. Taylor
By Army Maj. Aimee Ruscio, Ph.D.
August 12, 2019

“This is where it happens” was the first thought that flashed through my mind. What followed were several other thoughts about someone coming up from behind, bashing my head into the tile of the shower I was standing in, assaulting me, and the actions needed to defend myself. I have never experienced assault. The content of the thoughts were from a client I had treated about two years earlier. That client had supported a soldier in the immediate aftermath of a brutal assault.

It was odd. I wasn’t particularly bothered by the story at the time or in the two years since. Not any more so than other trauma stories I’ve heard during the course of my work as a military psychologist. I hadn’t felt that mild paranoia and sense of vulnerability on the deployment where both the event and the therapy sessions had happened. I hadn’t felt them at any point in the following two years. Even stranger, when the thoughts did surface, I was on a meditation retreat at a place that imparts a felt sense of safety similar to a grandmother’s house in childhood. In the moment, I brushed off both the thoughts and the fear. Rationally, I knew I was safe.

About two days later, an insight came out of nowhere. The fear I felt in the bathroom wasn’t mine. I was feeling it, but the story wasn’t mine and so the fear that went with it wasn’t mine, either. I was carrying them like someone else’s rucksack. They didn’t belong to me. I could put them down. The unconscious remnant of this old therapy session became somatic. I felt a restless, agitated energy in the front of my body, easily recognized as the same sensation that lingers after particularly charged therapy sessions. This was a familiar feeling and one with which I knew what to do: walk or jump up and down, shake my arms and physically return my body to baseline.

I found a quiet corner in which to move vigorously, incredibly uncommon behavior on a meditation retreat. It worked. In about 15 seconds, I was doubled over on the floor crying as a wave of grief and compassion passed through. Grief and compassion primarily for the survivor of the actual attack, who I never met, whose story was so profoundly painful and life-altering. And secondarily for myself for having carried some small part of that pain unknowingly for so long. I felt what I hadn’t had time or space to feel two years earlier. I put the rucksack down.

I share this story for two reasons. First, this is what emotional resilience looks like. Resilience isn’t being stone-faced, tough, or unaffected in the face of suffering. Quite to the contrary, it’s being able to be deeply touched, deeply affected and to still carry on. It’s about being present to our experience, in all of its intensity, staying open, and saying “yes, this too.” It’s about being honest with ourselves about what’s real, even when we’re hurting. As a psychologist, I know and believe this to be true. I've read Brene Brown’s research on vulnerability and authenticity. But I’m also a graduate of the United States Military Academy. Like so many other service members, I learned well and young how to suppress fear and accomplish the mission. Like so many other service members, there is a small part of me that wants more than anything to meet some imaginary standard of physical and emotional invulnerability. I also need the occasional reminder that the only way out is through.

Second, I want to make a case for the pressing need for and value of activities that allow us to slow down and get in touch with ourselves. Military mental health is a demanding business. Clinic schedules, deployments, management responsibilities, moving every two to three years, and family responsibilities keep practitioners moving so quickly. Human connection also has a speed. We cannot meaningfully connect with ourselves, our loved ones, or our clients if we’re moving too quickly. Like gears in a car, military providers need the ability to shift smoothly between the speed of the military and the speed of connection. Taking periodic breaks to reconnect with ourselves helps to develop that skill. For me, the form of the break is often sitting in silence on retreat. Many activities can provide similar respite: being in nature, creating, connecting with loved ones, journaling, making music, or dancing, just to name a few. So colleagues, how do you slow down and care for yourselves so that you may continue the work of caring for our nation’s service members?

Read Richard Harrison and Marvin Westwood’s article for additional strategies to protect against vicarious traumatization among mental health therapists.

Maj. Ruscio is an Army clinical psychologist and a clinical psychology subject matter expert at the Psychological Health Center of Excellence.


The views expressed in Clinician's Corner blogs are solely those of the author and do not necessarily reflect the opinion of the Psychological Health Center of Excellence or Department of Defense.


Comments

  • Major Ruscio -

    Thank you for your poignant and important message. Just as courage is not the absence of fear but the ability to continue the mission despite the natural fear we all experience, I see resilience in this case as the ability to recognize when you are being triggered, acknowledge the feelings, and as you said, choose to set down the ruck. Your story reminded me of the often-shared story of The Trouble Tree:

    The carpenter I hired to help me restore an old farmhouse had just finished a rough first day on the job. A flat tire made him lose an hour of work, his electric saw quit, and now his ancient pickup truck refused to start. While I drove him home, he sat in stony silence.

    On arriving, he invited me in to meet his family. As we walked toward the front door, he paused briefly at a small tree, touching the tips of the branches with both hands. When opening the door he underwent an amazing transformation. His tanned face was wreathed in smiles and he hugged his two small children and gave his wife a kiss.

    Afterward, he walked me to the car. We passed the tree and my curiosity got the better of me. I asked him about what I had seen him do earlier.

    “Oh, that’s my trouble tree,” he replied.” I know I can’t help having troubles on the job, but one thing’s for sure, troubles don’t belong in the house with my wife and the children. So I just hang them on the tree every night when I come home. Then in the morning, I pick them up again.”

    He paused. “Funny thing is,” he smiled, “when I come out in the morning to pick ’em up, there ain’t nearly as many as I remember hanging up the night before.”

    Thank you for your important message.

    David Preston
    Desert Storm Veteran
    Master of Military Social Work Student

  • We all should of had a trouble tree TSN in 1964. Not knowing who the enemy was trying and raise the hair on your neck when we saw the armed! Early on the field hospitals were like you see on the TV show MASH. Most were served well there but conditions were not the best! Travel on!

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