IJERPH Webinar

Invisible Wounds: Addressing Veterans' Mental Health Challenges by Centering Their Experiences and Perspectives

“Invisible wounds” is a loaded and potentially confusing phrase. I do think, however, that most of us intuitively understand it and when we hear the phrase many of us likely involuntarily feel something from our own histories poking us. 

I remember, years ago a woman veteran who had just started therapy with me at the VA one day saying how frustrating she found it that hardly anyone seemed to get that she was suffering terribly from the memories that haunted her of the rape she endured during basic training and the profound lack of support she experienced in the aftermath. She was not visibly injured—she had no apparent wounds. She was walking and talking just fine, so people questioned her service-connected pension, questioned how it was that she could still, after all those years, be unable to move past what happened. Why she still felt so unsafe that she hardly left her home. 

Other veterans were unable to shake their grief and shame around unit members’ deaths and their belief that they could have, should have saved them. These experiences left them feeling outside the pale—no longer a human in good or even ok standing. Other veterans spoke of how scared they were of being designated “the weak link.” The underlying reasons for these fears were myriad—some soldiered on when they were physically injured and others went to extreme lengths to hide who they loved—but the core motivations were to stay safe and not jeopardize their belonging. 

We cannot possibly list all the potential causes of invisible wounds that veterans and, really, all of humanity experience. Nor can we truly understand how invisible wounds are experienced by someone else (and, really, we are fortunate if we understand how they show up for ourselves). I do think it is fair, however, to say that when invisible wounds are present— and still unspoken and still wounding— they undermine our ability to feel safe, to have a solid sense of belonging, and to live with dignity. 

The veterans I just spoke of were courageously starting to speak of their invisible wounds, to start trusting someone with what had been unspeakable; an incredibly hard, brave first step. The three talks we are going to hear today reflect other brave steps veterans have taken to address their invisible wounds and they reflect some of the ways that veterans are showing up for one another—speaking up and out about trauma, injustice, and what they and their communities need to heal. 

First, we will hear from Dr. Cindy Chang and Ms. Amy Hoang who will present their paper entitled ““Do I Even Belong Here?”: Treatment Needs, Preferences, and Experiences of LGBTQ+ Veterans with a History of Suicidal Thoughts and Behaviors.” Dr. Chang is a research psychologist at the VA San Diego Healthcare System and assistant adjunct professor at the University of California, San Diego, and Ms. Hoang is a research assistant at the San Diego VA who has been instrumental in supporting the work they will be describing. 

Next, Dr. Kim DeFiori will present her paper entitled “Navigating Uncertainty in Care: Suicide Risk and Protection in LGBTQ+ Military and Veteran Healthcare.” Dr. DeFiori is a retired Army officer and postdoctoral fellow at the UNC Charlotte Violence Prevention Center.  

And finally, Dr. Louisa Kane will present her paper entitled “Finding Your People for the Journey: Women Veterans’ Reflections on the Role of Relationships in Substance Use Recovery.” Dr. Kane recently completed her internship in clinical psychology at the VA Puget Sound, and she is currently a postdoctoral fellow at the Center on Alcohol, Substance Use, And Addictions (CASAA) in New Mexico.