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David Vandegrift, Psy.D., is a 2017 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle

Dissertation Committee

Mark Russell, Ph.D., Committee Chair

Philip Cushman, Ph.D., Committee Member

Li Ravicz, Ph.D., Committee Member

Document Type

Dissertation

Publication Date

2017

Abstract

Military mental health clinicians (MMHCs) have been essential to Operations Enduring Freedom and Iraqi Freedom. They served in extreme stress conditions, including on the front lines. As co-combatant/clinician, the MMHC bridged unique perspectives on the effects of war stress experienced by Active-Duty Service Members (ADSMs). To date, no study has focuses uniquely on MMHCs narratives as they provided care from this multiple perspective. This investigation was carried out from a phenomenological perspective. A single, open-ended question was asked of seven MMHCs about lived experiences while serving, resulting in in-depth interviews. These were textually coded. Though clinician positive and negative experiences were consistent with previous research, significant differences bear discussion. Following data analysis, participants identified duty as the superordinate theme that led to the question, "Duty to military mission or service member?" This dilemma could not be reconciled that resulted in unrealized fulfillment of duty. MMHCs responses to unrealized duty defined an overarching polarity of Integrity-Corruption

A hermeneutic approach was used to identify the author's relevant understandings before, during, and after the interview process. In reconstructing and contextualizing interview material, one finding was that MMHCs were required to operate in a place of turbulence between contradictory military and psychological traditions. Another finding concerned a growing divisive fissure between military and the public at-large, impacting reintegration efforts for those who serve. Public and governmental silence about traumas of ADSMs and MMHCs suggests a parallel, cultural dissociation occurring about war trauma. A question is posed if diagnosing trauma as pathology is a further way that external, contextual forces are consistently kept unformulated, distanced or denied. Rather than locating the etiology and treatment entirely within the individual - resulting in blaming and isolating of those who serve - the suggestion is made for widespread discussion of socioeconomic and political factors that are behind psychological war injury. This dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLink ETC Center, https://etd.ohiolink.edu.

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David Vandegrift, Psy.D., 2017

ORCID Scholar # 0000-0001-9176-3406

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