This edited transcript is an excerpt from an interview with Judith Broder by Sam Coleman at Dr. Broder's office on October 18, 2007.

Judith Broder, M.D., originator and Director of The Soldiers Project,  is a psychiatrist and psychoanalyst who has a private practice in Studio City.  She is a Training and Supervising Analyst at LAISPS(Los Angeles Institute and Society for Psychoanalytic Studies) which sponsors The Soldiers Project through their  Ernest Lawrence Trauma Center.  More information on the Soldiers Project is available at their web site, www.thesoldiersproject.org  


SC  How were you originally called to the field of psychiatry?

JB  That goes way back!  I decided, I think, when I was thirteen years old to be a psychiatrist.  I read a book by Frieda Fromm-Reichmann and I thought she was a real hero to be able to work with such seriously disturbed people, to hang in there and be with them.  My Dad was a GP, and he raised us to be independent people.  He was probably one of the first feminists!  He told all of us, "I don't care what you do, but first you have to have a profession.  And then you can do anything else."  I actually went to medical school to become a psychiatrist.

 

SC  As opposed to choosing the specialty once you were in medical school.

JB  Right, or as opposed to psychology.  I might have chosen psychology if my father weren't an MD.  It was always about being interested in the inner workings of people's minds, how they lived their lives, how they were affected by their upbringings, and the ways in which a psychiatrist could help, by talking to people-because in those days psychiatrists actually talked to people. It was a completely different profession.  I went to a great medical school, the University of Chicago, and then I did my residency here at County Hospital.  Which was phenomenal because we were very much out in the trenches, and we had as supervisors people who were psychoanalysts, so that's how I came to be a psychoanalyst.  Frieda Fromm-Reichmann was a psychoanalyst, so many years later I was still right on track!

 

SC  Could you say something about the history of the Soldiers Project?

JB   I conceived of this over two years ago when we had our first meeting. It was a kind of initial planning meeting.  I began holding seminars about two and a half years ago, and collecting books to read. began reading.  That put us in a different mindset.

 

SC  I noticed from your web site that the Soldiers Project is in fact an outgrowth of the LA Institute for Psychoanalytic Studies.  Do psychodynamic approaches inform the work you are doing with vets?

JB  Always. It's certainly not the case that the soldiers and their families are being treated with psychoanalysis, but it is one of the very basics of our ways of understanding the complex issues.  It's the trauma in the context of what pre-existed, and it has taught all of us a way to sit with someone and be patient, to learn from what the person has to say, and not apply some protocol.

 

SC  I would imagine you would learn about, for example, what coping skills they have had in the past, what has made them vulnerable, and what would make them strong.

JB  Exactly.

 

SC  But how do you get these guys to open up?

JB  It turns out that we can, in our experience.  It's really easy.  It isn't hard.  The essence of it is, ‘I want to hear your story.  Tell me about you.  I don't know you or what you go through.  Tell me about it.'  There are guys who have been dragged in--virtually screaming--by their wives,  who are often the ones who call us.  When they get in the office and see that the person is not like the other people they've come into contact with who've been quote---"helpers"-- within the military and VA, they just open up.  In fact someone was telling me this yesterday about a soldier who came in, sat down, and just began to cry.  So it's much easier than we ever expected it to be, and it's actually much less frightening than people would expect it to be.

 

SC  Do you get vets demanding a higher level of secrecy, that is, being assured that no one is knowing that they are seeking the help?

JB  That's why they call us and not to the VA, because we spend a lot of time out in the community proving who we are, and making it clear that we're completely separate from any bureaucracy.  We see people in our own offices, and so  right away the setting is confidential.  They don't meet other people sitting in the waiting room or anywhere.  And we make it clear that the relationship is confidential, aside from what our license would require, which is reporting someone who's homicidal or suicidal, of course.  We'd have no recourse.  We have had instances where guys don't want to be redeployed, and they've asked us to write letters and be advocates.  There the confidentiality is broken with their permission.  Some of our therapists have taken on that role as advocates on a professional level, writing a letter describing what they observed, but they know it will be used for the purpose of  not being deployed because they have PTSD and are really not fit.

 

SC  In terms of outreach, I'd imagine that much of the participation results from the network of people who have experienced it, contacting other people who then come in.  The web page and brochure appear to have a broad appeal also.

JB  We wanted to cast as wide a net as we could, and make sure to capture all the people that get turned down everywhere else for whatever reason.

 

SC  And as part of that net, letting people associated with that vet know who you are and what you do is probably essential, too, because you'll be calling on them as part of the therapeutic process.

JB.  Yes.  A lot of the people we see are the wives or the moms, so our outreach is to go virtually to anyone who will listen to us.  We go where there are military family support groups, veterans against the war groups...we show up.  I've  shown up at the beach in Santa Monica, at the Arlington West memorial.  They know me now. "Oh, you're that Soldiers Project lady!  I talk to everyone about you!"  When we first went they looked at us (skeptically) like this:  ‘Who are you?  An older white lady who's going to come and help us?'  But being there-there's just no short cut to it.

 

SC  There isn't, is there.  You have to make yourself a known commodity, especially in this age where everything is just image, or telephone and e-mail.  People underestimate the value of face-to-face contact.  I'm sure that when you establish that contact and then ask, "I really want to hear your story," they know it's genuine.  So what is the scale of your project now?

JB   Here in California the network of providers is probably close to 120.  The Soldiers' Project in my conception is very complex because it's not just a referral list.  We hold seminars and peer supervision of people who are doing the therapy.   I have that many volunteers, [but] not that many have attended seminars.  All the referrals come through me.  I attempt to assign them to people whom I know have some special sense of what this population is and how you think about them and talk to them and so on.

 

SC  I would think that selection process is important.

JB  It is, because someone who gets turned off is gone.  I've learned to tell people who call, "Y'know, not every first match works,  so if this doesn't, call me back." and I've actually had a couple of people who called, so they must trust the first encounter with me to know that they can say that.  They say, "Well, it was too far away," or "It wasn't directive enough" -whatever words they use.

 

SC  Or the relationship is just not clicking.  That must be gratifying to you when they come back if the relationship doesn't work.

JB    It is.  Back to the scale of the project,  there's a group in Chicago and there is a group that has just formed in Seattle.  They're doing it independently but on our model.  And there is a group that is forming in New York City.

 

SC  Do they ever come by for a little technology transfer?

JB  I went to Chicago and that was good.  And one of our other people started New York.  The people in Washington spent a lot of time one the phone with me, and they get what the Soldiers Project is about.

 

SC  I'm sure they're kindred spirits.

JB  One of the wonderful things about the project is I have met people, sometimes in person, sometimes on the phone, sometimes through the internet, who are the most dedicated people.  It has broadened my experience of the world, and I've been enriched by others.

 

SC  How has your experience so far been with social workers?  Have you found a productive division of labor between social workers and others?

JB  All of our therapists are just therapists.  They hold all kinds of degrees-psychologists, social workers, MFTs.  They all have to have licenses and malpractice insurance.  There's no division of labor.

 

SC  Rethinking my question, I hope it didn't sound like I expected a hierarchy.  I'm still learning what a social worker is, myself, but I have the sense that one of the strengths of the field-- not always realized but one of the strengths-is that social workers blend their knowledge of clinical approaches and interpersonal skills with an ability to connect to resources on the outside.

JB  One of the things that we all discovered is that we all have become social workers.  It's not a hierarchical division.  In the majority of our cases we are called upon to reach out and use resources beyond just the talking.  That's an essential part of the training.  In fact a big part of the seminar I'm doing tonight is to discuss the pre-existing resources in the community that we can use for the people we're seeing.  That's unusual for many of us.  Psychoanalysts don't usually do that.  By the way the number 120 aren't all psychoanalysts but all different things.  Again, an outgrowth of our work is that we've become much more versatile in what is traditionally in the social work way, much less holding back from being concretely helpful.

 

SC  That's so interesting--could I ask you to elaborate on that a little more?

JB  As psychiatrists, psychologists, analysts, what we're taught is to understand meaning of things, and then assume that the person will make use of it in some practical, concrete way. The people that we're seeing in general need to be heard and meaningful, but they also need direct education, such as numbers they need to call, or services that are in such-and-such a place.  Sometimes, ironically, some of our work involves getting people back into the VA system where they're really entitled to care.

 

SC  And you say ‘ironically' because that's what some of them had rejected in the first place.

JB  Exactly.

 

SC  When you rely on other agencies,  what do you wish for? -I can imagine one answer would be a more responsive VA...

JB  Yes!  That's a given.

 

SC  But if you had a magic wand. what would those resources look like?

JB  More resources for families!  Because one of the limitations of the VA--and because we have a good relationship with them it's clear to us--is that if the soldier him- or herself doesn't sign in, the family can't be helped.  So the soldier has to identify himself as the patient, then there will be resources for the family-limited, but they're there.  But if a family member calls, and says they're in trouble, the VA will say "But I need your husband's number and he has to be registered here or I can't help you."  So there is a great need for family services of all kinds.  There's a need for counseling services, there's a need for and people who will work with schools, with kids who are troubled.

 

SC  I would guess, too, that economic counseling and assistance would be important, too.  A lot of families are strapped, and I'd imagine that any marital relationship would be terribly strained from that as well.

JB  Yes.  It is. I just had an e-mail from a woman in Florida.  She said her marriage fell apart and she had three children and she is struggling.  She said,  "I wish there were more of you," and I said, "Yeah, me too" [laugh].  Economically, the money they get is really not enough.

 

SC  From our discussion of the project, this to me sounds like a very welcoming environment and type of work for a social worker.

JB  Oh yes, absolutely.

 

SC  In terms of becoming involved, what's your message for us social workers?  Perhaps we could start with the things to study to prepare, things to read, things to expose ourselves to?

JB  I'll just tell you about our own growth process, because you need to know we all started out knowing nothing, just having good will.  None of us were experts.  We found books that looked interesting.  Jonathan Shay's book, and Grossman on killing,  we read Keith Armstrong's book, a kind of handbook that's phenomenal.  It has a very large section on resources that can't be beat.  It's not new anymore but it has resources including web sites. It addresses itself to soldiers themselves and their families.  For wives, it suggests how to be with their man when he comes home, how to figure out ways talk with him.   That's the one practical book that I'd recommend.  The others give you a more textured sense of what war is like and what returning is like.  We independently read things reflecting the mindset experiences of military families, and it made a difference. [SC Note:  A list of Dr. Broder's  suggested readings appears below.]

 

SC It's bound to.  They live in a different world.

JB  Yes.  It was really so for us, most of whom are sort of Beverly Hills, fancy upscale neighborhoods-

 

SC  [laugh] It makes you feel sheltered!

JB   It really really does.

 

SC It's harder for us to know the experiences of people in very different circumstances, but as humans we have that basic human capacity to empathize and to learn. for insight that can reach across those differences.

JB  This is the thing.  Everyone told us at the start, "They aren't going to trust you.  They're going to say, ‘What do you know?  You haven't been there."  But I think everyone in our project has taken the attitude, "You're right.  I don't know.  Tell me about it."

 

SC  I wonder how much of that skepticism is a defensive shell.

JB  Exactly.  The other thing that I think is extremely important, and I am very sensitive about-and Jonathan Shay is adamant about this--is that the providers need to support themselves, because the stories are horrific.  They're more than most of us really do want to know about.  So in a way we learn about it by reading, by seeing The Ground Truth, seeing plays, and we try to immerse ourselves in it.  But when you're in your office and the soldier starts to cry because of a seemingly innocuous but incredibly painful association with one of these experiences, you need someone else to help you with it, to process that to be able to be able to stay with the horror of that.  I don't know of any other groups that recognize this.  There are other groups in the country that have therapists available to help by providing free treatment and that's great, but I don't knew if there's a deep enough recognition of how shattering it is if you're really going to listen.

 

SC  And if you're really going to listen, and really be there with that person, you're going to share that experience with him or her.  This is where your own training for personal emotional hygiene as a therapist will come out in spades!  Because if you care you're going to be vulnerable.

JB  Yes.  That's what I knew, that we ourselves would need, and we could help each other.  So that ‘s what we do.  We have peer supervision groups where people would talk about what they're struggling with.  People in general don't know what soldiers have gone through, starting with what they are subjected to in their training.

 

SC  There's a misconception, too, that a soldier should be able to "snap out of it," or "just forget."  I have a pet theory that our human brains have evolved in such a way that they punish us for getting into life-threatening situations so that we will avoid them in the future.  If we could "just turn it off" the human race wouldn't survive.  So the feelings of stress represent an adaptive mechanism with survival value, but PTSD represents that mechanism in overdrive, if you will.  It's the guys who can just turn it off who are the real oddities.

JB   They become the Blackwater guys.  There are drugs available now that seem to be able to take the trauma away from the experiences.  The consequences are tremendously ambiguous.  I wouldn't want people to suffer from those experiences, but if they don't process the experience, what happens to the rest of their lives?  And someone has got to be a witness and say, ‘This is horrendous.'  You don't want all memory wiped out so there is no recognition of what has happened.

 

SC  You've said you are planning a conference on veterans' psychological needs.

Yes.  Our conference is called, "The Hidden Wounds of War-Pathways to Healing."  The dates are May 16 - 18 at the Bonaventure Hotel in Los Angeles.  This is our biggest venture, and our hope is that the conference will act as a catalyst for others to form similar projects in their local communities.  We welcome donations so that we can provide scholarships for veterans and their families to attend the conference.  [SC Note:  additional information about donating appears below.]

 

JB  I'd mentioned books by Jonathan Shay and Keith Armstrong. Both Shay and Armstrong are coming to speak at our conference.  We were able to attract these nationally recognized experts because we started this project a long time ago!  [SC note: the Soldiers Project web page and SASJ-C web page will provide information on the conference as it becomes available.]

SC  I hope we can help inform everyone about that.  Thank you so much for sharing your time today for this discussion.

 

--Some Recommended Reading--

Armstrong, Keith.  2006.  Courage After Fire:  Coping Strategies for Troops Returning from Iraq and Afghanistan and Their Families.  Berkeley, CA:  Ulysses Press.

Grossman, Dave and Loren W. Christensen.  2007. On Combat: The Psychology and Physiology of Deadly Conflict in War and in Peace (2nd Edition).  Jonesboro, AR:  PPCT Research Publications.

Henderson, Kristin.  2006. While They're at War: The True Story of American Families on the Homefront.  NY:  Houghton Mifflin.

Shay, Jonathan.  2003.  Odysseus in America:  Combat Trauma and the Trials of Homecoming.  NY:  Scribner.