Thank you for your service

Veterans Day is a time to recognize and celebrate the sacrifices made by all of the people who have served and are serving in all branches of the Armed Services. This recognition and celebration of Veterans happens around the country in big and small ways, by communities, businesses, and individual citizens. “Thank you for your service.” Five small words offered in gratitude. Five small words offered as a token of appreciation, knowing at some level that it pales in comparison to the price that was paid. Five small words that can sometimes be hard to hear, especially by those men and women whose military service includes trauma. Veterans who have been diagnosed with PTSD have talked with me in treatment about the complicated reactions they have to those five words, especially when offered by civilians. In the call of duty, Veterans can find themselves in situations and circumstances for which they were not prepared – situations and circumstances that force a choice between competing sets of values, where there is no way to make a choice that feels right on all fronts.

Before working in the VA, I never considered what it would be like for Veterans to hear the words, “Thank you for your service.” In fact, I’m sure I offered that phrase casually to Vets I knew on Veterans Day. It’s not that I wasn’t genuinely grateful. I was definitely grateful. I just didn’t fully appreciate why it might be complicated to hear those casual, albeit sincere, expressions of gratitude. To be fair, many of us feel uncomfortable when we are thanked for doing our jobs. Sometimes we respond by brushing it off (e.g., “it’s nothing special”), deflecting (e.g., “you probably could have done it better”), overthinking (e.g., does accepting the compliment mean that I am arrogant? Does not accepting it mean I am humble or that I am rude?), or by changing the subject altogether. The reasons for our general discomfort can be wide-ranging and include both global/stable and situational factors. For instance, some of us might be more comfortable being thanked by people we know well, whereas others might squirm less when thanked by a stranger. We might also feel more comfortable accepting gratitude when we feel good about having done something than when we don’t. For instance, if you worked with your local parent-teacher organization on a project that resulted in school improvements and feel good about your role, being thanked likely feels congruent with your own view. In contrast, if someone thanks you for managing a project where you weren’t able to accomplish as much as you had planned or would have liked, it might be harder to hear – your reactions to the gratitude might be more complicated (e.g., “Do they really mean that? Or, are they mocking me?” “If they really knew how much I was supposed to get done, they wouldn’t be saying thank you,” “I bet Linda could have done a better job. They really should have asked her to do it.” Etc.).

Similarly, Veterans who are thanked for their service, especially those who experienced trauma or moral injury (events that “transgress deeply held moral beliefs and expectations”(1)) as a part of their service, can have complicated reactions to being thanked. The National Center for PTSD notes that the percentage of Veterans diagnosed with PTSD varies by service era (2), however, it is estimated that between 11 and 20% of Veterans who have been deployed have PTSD. PTSD can also be diagnosed following other types of military trauma (e.g., Military Sexual Trauma, training accidents involving loss of life, etc.). Although some types of trauma that are experienced by service members may be similar to those experienced by civilians (e.g., sexual trauma), the military context can add a complicating layer. One of the primary aims of basic training or boot camp is to prepare new recruits to be ready for battle and although each branch of the service is different, in all branches, part of that readiness includes fostering a sense of loyalty and pride. Unfortunately, often due to circumstances outside one’s control, some experiences had while serving leave Veterans with the burden of assimilating those experiences into their previously held beliefs about themselves, the world, and others, or accommodating their beliefs to fit these new experiences. Some Veterans don’t feel as proud of their service because of things they’ve done, things that were done to them, things they witnessed, lives they couldn’t save, lives they had to take, secrets they were forced to keep, and emotions they were taught to stuff. Therefore, expressions of gratitude for their service can feel complicated (e.g., “Would you still say thank you if you knew how I blame myself for lives that were lost as a part of my service?”).

“Thank you for your service.” Should we still say it? Yes – if you want to. Expressing gratitude to Veterans can be thought of the same way we think of expressing gratitude to anyone – gratitude offered with sincerity is gratitude worth offering. We don’t need to stop expressing our sincere thanks for fear it might make someone uncomfortable. Just know that if the Veteran you are thanking doesn’t seem at ease with your gratitude, there may be a lot of complicated meaning in those five words.

More information about PTSD, moral injury, and Veterans can be found at www.ptsd.va.gov. Here you can also find information about evidence-based treatment options for PTSD available in VA.

References:

1. Litz, B.T., Stein, N., Delaney, E., Lebowitz, L., Nash, W.P., Silva, C., & Maguen, S. (2009). Moral injury and moral repair in war Veterans: A preliminary model and intervention strategy. Clinical Psychology Review, 29, 695-706.

2. https://www.ptsd.va.gov/understand/common/common_veterans.asp