The case of the soldier who failed to return: Reflections on psychodynamic psychotherapy with combat veterans

• Published in: Journal of military and veterans' health. Vol. 30; no. 3; pp. 20 - 27
• Main Author: L D Connor
• Format: Journal Article
• Published: Canberra Department of Defence 01.07.2022
• Subjects: Anxiety; Armed Forces; Medical care; Methodology; Patients; Psychodynamic psychotherapy; Psychotherapy; Services for; Veterans
• ISSN: 1835-1271

The effects of war on combat veterans' mental health are numerous and well established. Several effective interventions exist based on cognitive-behavioural therapy that aim to reduce the symptoms of anxiety, depression and PTSD that many veterans struggle with. However, little attention has been paid to psychodynamic psychotherapy and documenting its use in treating the sequelae of war trauma. Furthermore, very few writings discuss how working with combat veterans within a psychodynamic framework can affect the therapist. This paper presents the case of 'Sam', a combat veteran who suddenly disappeared from psychotherapy after some years in treatment. The author reflects on the issues that arose in this course of therapy with the aim to stimulate further reflection in practitioners working with veterans drawing upon a psychodynamic model. It is hoped that readers and organisations supporting veteran mental health will develop an appreciation of the intricacies of psychodynamic psychotherapy with combat veterans, understand the importance of the therapeutic alliance, appreciate the impact that working with combat veterans may have on themselves and the importance of seeking and maintaining high-quality supervision and reflection.