My guest today is Pip Weiland. She commissioned into the Australian Army Psychology Corps in 2003, and in her career performed diverse roles across clinical, organisational, professional development, research and staff positions. She has deployed to the Solomon Islands, Iraq, and to Afghanistan on two occasions. Whilst deployed to Afghanistan, she was the lead in the critical incident response to Australian Army soldiers killed in action. She ended her military career in 2020, as the Commanding Officer, 1st Psychology Unit.
Pip was awarded a Conspicuous Service Cross in the 2018 Queen’s Birthday Honours for the superior management of several sensitive, high-profile matters including the immediate psychological response to witnesses to the death of a soldier in training.
Pip is passionate about evidence-based treatments and has a special interest in psychological resilience and the mental health issues associated with exposure to combat. She is now a Regional Director for Open Arms – an organisation focused on providing mental health and wellbeing support for current and ex-serving Australian Defence Force personnel and their families.
Some of the topics we covered are:
- Psychological screening on operations
- Stigma surrounding psychological treatment
- Truth about ongoing employability despite mental health challenges
- Critical incident management in response to death on operations
- The importance of the ‘tribe’ for mental wellbeing
- The process of identity creation in the military
- Suicide rates in defence members
- Treatment of mental health challenges
- Services offered by Open Arms
This was another hugely insightful episode that touched on many aspects of mental health challenges experienced by veterans and their families. For our Australian audience, particularly around ANZAC Day, please look out for one another and reach out to any of the numbers below if you or someone you know may need a helping hand:
All-hours Support Line
(1800 628 036 / +612 9425 3878 if O/S)
Open Arms (VVCS)
1800 011 046
(1800 624 608)
Defence Community Organisation (DCO)
Defence Family Helpline
1800 624 608
13 11 14
Suicide Call back service
1300 659 467
1300 620 380
Philippa (Pip) Weiland – Perspectives of an Army Psychologist
My guest is Pip Weiland. She was commissioned into the Australian Army’s Psychology Corps in 2003 and, in her career, performed diverse roles across clinical, organisational, professional development, research, and staff positions. She has deployed to the Solomon Islands, Iraq, and to Afghanistan on two occasions. Whilst deployed to Afghanistan, she was the lead in the critical incident response to Australian Army soldiers killed in action. She ended her military career in 2020 as the commanding officer of the first psychology unit.
Pip was also awarded a Conspicuous Service Cross in the 2018 Queen’s Birthday Honours list for the superior management of several sensitive high-profile matters, including the immediate psychological response to witnesses to the death of a soldier in training. Pip has a Bachelor of Arts degree with a double Major in Psychology, her postgraduate diploma in Psychology, and a Master of Organisational Psychology with a distinction. Her thesis focused on enhancing resilience in a military training environment.
In 2013, she graduated with a Master of Military Studies from the Australian National University and also completed a postgraduate certificate in coaching Psychology in 2018. Pip is passionate about evidence-based treatments and has a special interest in psychological resilience and the mental health issues associated with exposure to combat. She’s a Regional Director for Open Arms, an organisation focused on providing mental health and well-being support for current and ex-serving Australian Defence Force personnel and their families. Pip, thank you for joining me on the show.
You have an amazing career. Reading that bio, it’s incredible how much experience you have over seventeen years in the Army. Before we delve into all of that experience, maybe we can start with a simple question, what made you join the Army in the first place?
It’s a good question. I’m an Army brat. I’m the fourth generation of the Weilands to make Army a career. I grew up around the military, and there were lots of positive things about that. It’s a very supportive environment. I also grew up seeing what the impact of mental health are on families and friends when it’s not addressed or managed. I was very passionate about joining the Military, but specifically as a psychologist to see if there’s more that we could be doing while people are current serving, to have a good impact on them, but also for family and friends.
What obviously stands out there is that growing up, you’ve seen the impact of military service on families. Do you mean your own family?
That’s right. My father was a career Army officer, and so was his father and his father’s father. I was quite lucky, when I did join, they introduced a lot of very positive screening tools, for example, and new regime of how to support current serving with their mental health issues. When I joined in 2003, they introduced the psychological screening system, where everyone that deploys, gets the opportunity to speak to a psychological examiner before they return home. It was a very rewarding period to start.
It was 2003. This was the beginning of after the first few years of the Australian Army becoming deployable again and operational after what was commonly referred to as a Peacetime Army. Was that then the reason for psychology? Had you had an interest in psychology previously, or was it driven by the fact that you’ve seen the impact on your own family by service life?
I’ve always been interested in human behaviour and why we do certain things. As I was going through university, I was a bartender. I joke and say the real psychologists out in society tend to be our bartenders, our hairdressers, and our taxi drivers. I make the joke about, “I want to be a psychologist because I’ll get paid more minimum wage for discussing people’s issues with them.”
Throughout your career, and quite extensively, you’ve done a number of deployments to the Solomon Islands and Iraq, and as I read out in the bio, twice to Afghanistan. Was this all then in psychology roles?
Yeah, that’s right. It was an interesting time to join in 2003 because, as you mentioned, that’s when we started getting back into deployments. I found within the first eighteen months, I had my first deployment and then it carried on from then. It was and exciting and intense period.
Where was that deployment?
That was to Iraq, and that was to do psychological screening for a rotation.
For troops coming back?
Yeah, that’s right.
What does that involve? A lot of our audience will be familiar with the post-operational psych and the screening process, but those who haven’t served might not understand what it is or its value. Can you describe why we do it and what it involves?
Some of the audience might remember having had RtAPS, which is Return to Australia Psychological Screening. Before returning home, they obviously have medical checks. What they introduced, and it was around that period of 2003, was to have a session with a psychologist or a psychological examiner, which are our psych soldiers, and filling out paperwork, like a psych assessment, so answering survey.
What that’s trying to do is to screen for any mental health disorder, but then it’s having the opportunity to actually sit down and speak for up to an hour with a psychologist about your deployment experience. We found it very useful, not just for you trying to get that early intervention by being able to pick up perhaps problematic symptoms early. It’s also a way where people can debrief about their deployment experience and there’s value in that.
I’m reflecting on what it was like before going home. It has two phases to it. The first one, as I said, was the RtAPS. There’s a Post Operational Psychological Screening, the POPS. We do that 3 to 6 months after someone’s returned. That’s to see how those symptoms are going, and everyone gets that as well to see if they go away, and often they do, or if they’re still perhaps a bit problematic and we’re up to the six-month mark, it might mean we need to get extra support for those people.
I remember distinctly going through those processes myself. What’s your feeling that you are out of the Defence Force? How successful were those processes?
They are very important, not just for the psychological symptoms and picking up on those. What we picked up as well were organisational factors. There are a lot of questions there about what was the leadership and morale like, and we’re able to use outcomes from that to better prepare for new operations.
Psychologists, there are not many of us, and to use them to mostly screen a healthy population, that’s a luxury to be able to do. One of the great outcomes when you implement something where every single person has to do it, it impacts the stigma associated with it if everyone has to do it. It normalized it’s okay to see a psych. We all have to, anyhow. It will help, I believe, if that’s your first introduction to a psychologist. You might, if you have issues down the track, not be so resistant to actually going to get assistance if you’ve already had that introductory experience.When you implement something where every single person has to do it, it impacts the stigma associated with it if everyone has to do it. Click To Tweet
That’s interesting. I had never actually thought about it in that way. You’ve got a huge amount of data to work with to understand the organisational pressures and how the organisation is managing the exceptional stress of deployments in combat. That’s an important point of reducing that stigma because that is one of those things. I can speak from my own personal experience going to a site while on deployment as well as post-deployment or pre-deployment. There’s always this, “What can I say?”
We all want to go and do our job. There’s a stigma surrounding the idea of going to speak for the sites because they might hear something and prevent you from deploying or from doing your job. Certainly, in my time that I’ve spoken to people, many would actually say that it’s ticking a box. Going to see a psych, you know what you need to say and what you’ll answer. What would you say to those people? I know it’s a difficult question.
I have been asked before. They’re like, “Do soldiers actually ever speak to you?” All those concerns that you’ve raised there. In that private space when we do one-on-one, they do. I suppose you can see this both ways. It’s positive and negative. Thankfully, I’m always incredibly busy as a psychologist, like booked out. That means people are using those services. I suppose the negative is they’re required to that extent. I do find that people are very open once you have that rapport and that trust.
It’s interesting what you raised on some of the concerns you had. They reflect what we’ve seen in survey results. It’s not so much the stigma about, “Why go to a psychologist? What use would they be?” because that’s an area of stigma. It’s more within the military. People are concerned about going to see a psychologist because it will, perhaps, impact their employability or that’s what their perception is, and it will impact their ability to deploy again.
On a previous episode, I spoke at length to Ashley Judd, whom I know you and I spoke about separately. He expressed that quite clearly. He ended up suffering from PTSD due to his experiences. That is a real hurdle for people to overcome when going and seeking professional help. I’ve always found that it’s useful. Correct me if I’m wrong, but you’re trained to the point that you are able to see where the red flags are over a period of time. There’s also a comparison of how a person responded before they went, to how they responded when they came back. All this analysis is arguably done. Am I correct in that?
Yeah, that’s right. These concerns are about impacting employability and deployability. At times, it can, and that’s protective of the individual if they’re not well to go back into a war zone and is likely to exacerbate the symptoms. What we do know is about 1 in 5 current serving members have experienced mental health disorder in their lifetime, and these people still deploy. It’s about getting that help managing it because if we didn’t think that people could change or we’re able to learn skills to manage it, we wouldn’t have psychology. That’s what it’s all about. It’s identifying those symptoms and getting more control over them, managing them, and then being able to continue employment and to deploy.
That’s a powerful insight and that’s part of dispelling this myth. That’s a powerful figure, 1 in 5 of us has experienced some mental health challenge. That’s real insight. That’s 20% of the force, but people are still deploying. Maybe that’s part of the challenge is to look at mental health like breaking your arm. Things heal. We are getting better obviously because of all the work that people like yourself have done over the years, but we still look at mental health, and this is going to impact me severely. To bring Ashley in again, he said even though he suffered severe PTSD, ultimately, after his treatment, he was again potentially deployable even though he chose a different career path for himself from there. Those are interesting insights. Do you have any comments on that?
It’s good to hear from Ash Judd because that is the case. We have that concept of resilience. What we’re not looking for is for someone to never have experienced a mental health issue. As we’ve pointed out, 1 in 5 do, but it’s more about how they manage it, how they bounce back, and how they go forward. There are many people out there that are managing mental health issues and still performing at very high standards and are able to deploy.
To echo that as well, I’ve been out of the military for nearly seven years, and I came back in. I was warmly surprised that people are openly saying, “I’m in treatment for X, Y, Z,” which is very different to when I left in 2013. Certainly, there seems to be a different vibe about this idea of actually seeking help, that it’s not something that’s frowned upon. That’s certainly a very positive change that I’ve noticed in the short time that I’ve been back. You’ve had a particular experience during a tour in Afghanistan, which was the Critical Incident Response Management. What happened? Can you talk about that?
I look back on that deployment in 2010 as the most rewarding experience in my military career, and one of the most rewarding experiences I’ve ever had in my life in total. I don’t think I’m alone with that. Deployment often comes up for veterans as one of those rewarding career highlights. It was rewarding, but it was also very challenging as well. I went over there. I was based in Tarinkot, and I was a relatively junior psychologist still. Within the first four weeks I was there, we, unfortunately, had seven Australian soldiers killed in action. I was straight in there, and it felt overwhelming for all of us because it was in a very short time period.
It was very interesting to see how we all reacted to this. It was positive I saw in this experience. I was busy as the only psychologist at Tarinkot. Although I saw a lot of very heightened emotion, as you would expect, because it provides that psychological response almost a few days after an event occurs. When I refer to it being rewarding, it was the level of resilience that I saw in the task force as a group and how they responded. The quality of the leadership, particularly from juniors like lance corporals, corporals, and captain level, was incredibly impressive. I’ve been very lucky to have been able to see that for myself on the ground.
I’m sure there are many people that are grateful that someone of your empathy and skill was there to help. Can you maybe describe what you mean by Critical Incident Response? What does that involve?
I’m happy to take you through that. That’s actually quite a formal system. It’s very much like the screening system we have for the Return to Australia Psychology Screen. What I wanted to point out here is it’s important to know. I don’t think it is well-known. If there is a critical incident, for example, if someone is killed in combat, we actually send a psychologist forward, not exactly where the event occurred, but to afford an operating base to provide that psychological assistance. It’s important to know for those that might be back home, particularly parents and partners, that if something does go wrong, we send the padre. We sent a psychologist forward to provide that important support. We tend to do that a couple of days after the incident in 2010.
It was interesting to see what it’s actually like to provide psychological care in a war zone and in response to a crisis. I’ve been trained in things like prolonged exposure therapy for trauma, but they’re not the skills that I was using in response to a crisis. What it looks like on the ground, we work on what’s called the PIES Principle, and that’s an acronym that stands for Proximity. We send psychologists forward close to the people, and the actual event.
I is for Immediacy. We try to do that shortly after the event. E is for Expectancy. That’s based on the concept of resilience, that the majority of people will do well, and that their expectation is once people have stabilized, they go back out and continue their job. The S is for Simplicity. You’re not using those in intensive psychological skills like Prolonged Exposure Therapy. Often, you’re using what they refer to as Mental Health First Aid. It’s a lot about grounding people and calming them down, so that they’re able to go back out and continue with their job.
I found it interesting that you said you go in a couple of days after the incident. Is there a particular reason why those couple of days we don’t want a psychologist in there?
There is. That’s based on best practices. What they found throughout the years and lots of different incidents that it is not helpful if the psych turns up immediately. It’s because of what we know about response to trauma that the best thing that people can do is rely on their normal coping skills. That builds resilience as well, with people knowing that they’re able to try to respond to an event themselves, that builds that confidence.
We know the importance of social support. People on the ground supporting their mates and getting through it that way. What you can see after a couple of days, when people have settled a bit, and the vast majority do over a few days, the psych will come in and do that assessment to see if there’s anyone there with any concerning symptoms. It’s focused on supporting those natural behaviours that we all have, how we would cope if something bad happened, and we would be relying on leadership and our mates.
This again goes to the point that you raised about how rewarding it was to see resilience and leadership. It also makes sense from a sense of identity perspective. You are in a very distinct in-group combat zone. For anybody that’s deployed knows how strong those bonds can be between that particular in-group. When something like this happens, of course, it’s going to be the in-group perhaps that galvanizes and becomes even stronger because of that adversity. It’s also that in-group that will validate, support, and reframe that particular incident with that particular unit. That goes a little bit to that point of why deployments, in general, are rewarding because we train hard, and then we go out to do a job. You are out there on your own with your mates.
I can certainly think of many people that I’ve spoken to that would echo what you said. Deployments are generally viewed as one of our most rewarding experiences in life. It’s also maybe because of a sense of purpose that when we deploy, and we have a mission and a vision that we’re trying to carry through. That sense of purpose is perhaps also critical, maybe also in the post-care. I wonder if it is, and that’s probably a question for you. Is reinforcing that sense of purpose when we deploy overseas part of that recovery process, as you said in the PIES process?
It’s very much so. That’s what helps people cope as well, those things that you’re referring to, that leadership, the mateship, all working together for a common outcome. That’s why we don’t like to evacuate people out that are having a mental health response if we don’t need to because it is so important that they stay with their unit or team as they’re recovering if we’re able to do that. A sense of purpose comes from the heart.
When we see people having difficulties in the transition out of the military, it’s not just a bit of this when they’re returning back to Australia and often, they get posted elsewhere. The team breaks up and may be struggling with that sense of purpose, but we do see that with those that struggle to leave their military career. I feel that it’s related to a loss of identity, and some of that loss of value or a sense of purpose in life, which was, from my experience, what I’ve seen of others, so evident when you are in a deployed environment.
That’s what the military does. It breaks down your previous social identities and gives you a new one, one that is very attractive. It is broadly respected in society and has a whole bunch of values and norms that most of us would consider being quite moral and noble in many ways. For me, as a male, if I recall, the first thing you know is you shave your head. You get broken down, and then built through the hardships of your initial training into more or less a cohesive unit, depending on where you start off with. It then diffuses a sense of purpose and value that you’re sharing with. That would then make sense.
I had written down some notes previously as well, but one of the things that struck me, and I’m not sure if this is a good time to dive into this particularly dark subject. Since you mentioned aftercare, it’s a well-known fact that we have more than 500 veterans who’ve committed suicide, which is dozens of times more than we’ve lost in combat. There’s a particularly sensitive group, and that is the 18 and 24-year-old males who’ve been medically discharged. They have four times the national average suicide rate. To go to your point about purpose and identity, do you think that’s a principal contributing factor, particularly for that social group?
It’s interesting when we talk about that younger group, and as you’ve pointed out, there are statistics to demonstrate that. They’re a particularly at-risk group and in transition. It also mirrors what I had noticed in providing that psych support on the ground overseas. I was particularly aware of the reactions from the younger soldiers. It seemed to be a pattern where they struggled more. There’s a little bit about why that is. I suppose some of that might be related to the maturity and experience you get spending a long time in age, but also in that career. You’re right about transition as well. It’s not poignant for that younger age group. It’s about who they are now, the identity piece, and their meaning going forward.
It’s almost like, “Who’s your tribe now when you leave? Who do you relate to?” I’m quite passionate about the importance of looking at these psychosocial factors in transition. It’s not just about how to write a resume. There needs to be that discussion about who you are now. They refer to it as those that tend to do better in transition, and look at their military experience as a rewarding or a challenging chapter, but it’s not the entire book. Who are they now? It’s not your rank anymore or your PMKeyS number, but who is Bob, Peter, or Sarah? Who are they going to be stepping forward? They’re conversations that we need to have more and to reflect on that.Veterans going on a transition is not all about writing a resume. There needs to be a discussion about who they are right now. Their military experience should be a rewarding but challenging chapter, not the entire book. Click To Tweet
Listening to you, it makes absolute sense. We also know from an evolutionary perspective that particularly males in that age group, probably even earlier than that, have twenty times more testosterone running through their bodies. Testosterone being a status-seeking hormone, we know that young males are more prone to high-risk behaviour, which of course, the military could be classed as. They’re also looking more for that tribe, that sense of belonging, that sense of identity.
That resonated with me when you spoke about that because that partially would explain if you’ve been through this strong bonding experience in a social group, i.e. the military, especially if you’ve then gone through some serious hardships, whether that is through your training or even on deployment, and then you are medically discharged or you leave. If this is the only “tribe” you have developed or become part of, and that’s taken away from you at that rather tender formative age, it does make sense why taking one’s life seems like a way to still that severe emotional distress that such an experience would bring. You are in an organisation that deals with these types of challenges to help people deal with mental health issues. How does one do this?
How do we overcome mental health issues? I’m very passionate about evidence-based care. What we know is one of the best outcomes comes from trauma-focused psychotherapy, like Prolonged Exposure Therapy. That’s part of what we do in my organisation, but then it’s also supported by your general health and well-being. There needs to be support for things like finances, relationships, families, and building all that up. We live within a society, within a family structure. It’s important to be supporting all those areas as well to be able to stabilize and go forward.
The social network support, a sense of purpose, income, maybe we’ll then come back to that. I’ll backtrack to illuminate some other points, but how do traumatic events develop into mental illness?
I’ll respond to this in layman’s terms, and I might focus on Post-Traumatic Stress Disorder in particular. I’ll relate that back to exposure to combat or war zones. When we’re under immense stress or we feel we’re in a position where our life is in danger, or the lives of those around us are in danger, we go into survival mode. That survival mode, you see it in all animals. It’s a fight-or-flight response, and that kicks in so that we survive in the end. It’s very useful, and incredibly adaptive when we’re in that environment. What we see down the track, though, is people can return, be out of that environment where they’re not in that level of danger, and they’re still showing those fight-or-flight responses.When we're under immense stress or in a position where our life is in danger, we go into survival mode. It's a fight-or-flight response that kicks in so that we survive in the end. Click To Tweet
They might be doing it not because in reaction to a firefight, it could be picking up threats in a crowded place, but they’re still having that heightened survival response to that. It’s almost like the switch hasn’t been turned off when they’re in a safe environment. PTSD is not the only mental health issue people can have having been exposed to trauma or to combat in a war zone. We also know that there are high rates of depression and anxiety. People talk about moral injury as well and having feelings of shame and guilt about actions or inaction they perceived they did or didn’t do. There’s that, which isn’t often talked about, the command guilt as well. Making a decision which you feel resulted in the death of someone and having to reflect on that and move forward.
There’s a whole span of different experiences that people might have. Is there any kind that throughout your experience particularly dealing with soldiers in combat, conditions that are most prevalent that due to the nature of the work, there’s a standout trigger, cause, or type of mental health issue?
The two ones where I see, and I would be predicting they more likely have an intense mental health response to is combat in a situation where you thought your life was in danger and those around you were in danger, witnessing the death of someone. We can imagine being exposed to an IED blast that resulted in death is an incredibly intense scenario. You can imagine the amount of trauma that exposes you to.
The other, we tend to see this more with those that have been on UN missions. People talk about having quite strong mental health responses to being in a position where due to the rules of engagement, you weren’t able to act to save civilians. That is more along the responses of feeling guilt for what might have been perceived by that individual as not acting or being restricted in that situation.
That intuitively makes sense. For the first one, being exposed to the sounds, the sights, and the smells of exceptionally traumatic death around you, would certainly have an impact, and of course, the inability to do something. You mentioned moral injury. Would that be a full part of moral injury?
When I have clients, I presume that they have a moral injury from a scenario. It tends to be those situations where something happens, and they weren’t in a position to act in accordance with their own values because they’re restricted at the time, or it’s about being exposed to things that go against your own values. Some of these might be cultural differences, for example. Coping with those things.
Go back to that moral injury piece as well. We’ve talked about a sense of purpose when people deploy, and we go forth with idealized versions of our contribution, and what we are going over there to do. Most of us put our hands on our hearts and say that we’re going over there to do good to help people. When we then deploy, and oftentimes, we see that maybe this is too big a problem as one part, or maybe even my contribution is perhaps part of the problem rather than the solution or our overall mission. This is something that’s been questioned a lot over the past couple of years. Do you find that theme pops up with particularly those who have left the ADF?
It’s interesting, that’s impacted quite a lot by media who are viewing it from a different lens. People might deploy and have that real sense of meaning and that they’re over there to make a very positive contribution, and then returning home and seeing that reflected from a different perspective from media who may suggest that it wasn’t worthwhile or perhaps causing harm. At times, you’ll have people that take that on board and reflect, and it might change their feelings about their deployment.
I’d imagine that will be a challenging thing for you and members of Open Arms to deal with because we are so bombarded by media everywhere we turn. If there is the latest narrative of the day, then that might have a significant impact on those who have served. Is that right?
Yes. You can see it with the Vietnam veteran cohort in particular, as we all know, on their return to America and Australia, feeling a perception that they may not have been supported by the population for that. People refer to that as having an impact on the mental health of that cohort. What I see as well, because in this new role, obviously we’re providing support to Vietnam veterans as well, is it re-triggers when we see current, perhaps, negative perceptions about deployment or the Australian military in the media. It is almost re-triggering to that cohort because they can relate to what it felt like not to feel supported by the population.
That’s interesting because, in the current climate, there is a lot of that guilt being forced upon veterans. It doesn’t matter what conflict. Eventually, it’ll pop up, and it’ll be questioned in some sense. Is that helping current veterans from the more recent conflicts to have the Vietnam vets as mentors on how to deal with this pressure?
You see a lot on social media comments from veterans from different operations, and what I’m seeing is a strong theme of them being supportive of Afghanistan and Iraq veterans. That is a very positive thing. I feel like the veteran community is a supportive space at the moment.
Maybe because I’m a veteran myself, but I certainly sense that it’s getting stronger. There’s a field that there are a lot of organisations out there that are seeking to help veterans deal with any issue they might have, whether that is transitioning into civilian life or organisations like yours that help with mental health and other types of support. Have you found in your experience, that there’s a difference in the way conflict affects men and women?
That’s an interesting point because I was actually looking back on it. Having been a military psychologist, the vast majority, about 90% of clients I’ve ever had, have been men. It’s quite rare to have female clients. What I did notice is there were a lot of similarities between responses as a human, not gender specific. For example, if someone’s killed, males and females equally, expressed grief. I feel that men may not feel comfortable because there’s judgment about expressing things like grief or fear publicly. The actual human reaction to big events, I did find interesting, it was similar between different age groups and whether you’re male or female.
Being over there in the war zone, I was in a positive way to see how much empathy and compassion males had towards each other in coping with a critical event. For example, I had a senior officer express to me. He goes, “I don’t know what’s wrong with everyone. I don’t know what’s going on. They’re all crying. They’re all hugging each other.” He was surprised by that. My response is, “That’s a perfectly normal reaction. We actually want to be part of an army in which people are highly distressed when someone’s killed and that they do show that compassion to each other in moving forward.”
Like you said, it’s a human response to an inhuman or inhumane event. I guess the act of killing itself is rather obviously inhumane. That’s interesting to hear. It makes sense why you wouldn’t have seen many females. We still have far fewer females in the military than males, but also in the frontline units. This is maybe a question because I need to question my own bias based on what I’ve heard elsewhere as well. Perhaps there’s a perception that it is the frontline units, those that go out and are fighting. Those are predominantly male. Maybe it’s a bias to think that they are the ones suffering the most mental health issues. Is that true, or are people suffering mental health issues regardless of what type of job they do when they’re on deployment?
There are two parts to that. I’m glad you raised it because I’ve been thinking about it as they’ve been speaking. My comment before was that I noticed that it was the younger men that were struggling with mental health issues, but when you look at it, those who are on the front line tend to be male and tend to be younger. There’s more exposure to these types of things. That’s quite a simplistic answer that I didn’t identify. It is the young males that tend to be on the front line.
The other part of this is no, you can have strong mental health responses and experiences without being deployed. We know that. We’ve seen the stats for that. It can impact people that weren’t exposed on the frontline. Part of this as well is when we talk about trauma response to things like combat or being in a war zone, we have to remember it’s a very individual response.
There’s not a blanket generalisation or strong direct correlation. Part of this is because you could have five people exposed to the same event, and their responses will be different because we’re not blank slate when we turn up. We have our own histories, and we may be triggered in different ways. We see the event through our own individual lenses. In relation to that, it’s an unfortunate thing. Mental health, anyone can experience that, and some of that is dependent on their own life experience.
This is the importance of having those multiple touchpoints of psychological support. If you don’t mind, I want to go back to the huge issue of veteran suicides because that’s something that’s rightly starting to get a lot more attention. As I mentioned before, we’ve lost more than 500 veterans to suicide. Do you have an explanation as to why the rate is so high?
It’s interesting. There seem to be two large groups here. What I mean by that is when we look at the statistics and rates of suicide, the rates are less for current serving members than the Australian population, which suggests that there is something protective about being in Australian Defence Force. Having said that, what we know, and you’ve pointed out, particularly for that younger group, it’s on transition where we’re seeing a much higher likelihood for things like suicide ideation and attempts for those that are ex-serving and have transitioned out.
As you’ve rightly raised, why is that? Why does it increase? I went to a frontline mental health conference, which involved the police, the fireys and the ambos. When they talk about their stats, they see a spike for those that are ex-serving. When we talk about what is protective, it’s about that feeling that you are well-supported, have that good social network, have good leadership, etc. There’s something about a transition where it’s adapting actually to a new lifestyle, and perhaps a new identity, that is problematic for some.
It resonated again with me that notion of the tribe that you mentioned before because the more I think about it, it makes intuitive sense. I’ll have to fact-check myself on this, but I’m pretty sure I’ve read somewhere that collectivist societies have far lower incidents of mental health issues than individualistic societies like ours, which goes to that point. I can think of Sweden. We lived in Sweden for three years. Sweden has one of the highest suicide rates in the world, and one of the highest, if not the highest, rates of anti-depressants.
It is one of the most individualistic societies in the world. Perhaps there’s a link. Maybe I’m reading too much into, but it would make sense. If you’re saying that other services or other security services are experiencing similar issues, then there’s certainly some level of commonality between this idea of the tribe, and we are so tribal in the Defence Force that it would almost make sense that that is a key contributing factor. Maybe going off from that, what are we getting wrong then? Why are we unable, as a society, as in institutions, to stem this horrible reality of veteran suicides?
We are changing. I agree with what you’ve said about individualised versus collective societies. My understanding is, as you pointed out, the rate of suicide is less for those collective societies. We can draw that link perhaps to the concept of the tribe. What I’m passionate about and what we’re trying to put more emphasis on is during the transition period. Looking at what it is people struggle with, and there’s been some good work in this space by the Gallipoli Medical Research Foundation. They’re looking at a program called Go Beyond. It’s identifying through interviews with many veterans for those that do well on transition, what was useful for them, and for those that struggle, what it is that they’re struggling with.
It’s interesting that there are things that they’ve come up with because, as a veteran who’s only recently transitioned from the Military, I do relate to some of these things. It’s looking at what social supports you have, hobbies, and meaning outside of your actual job. It’s your social connection. It’s about how you feel and reflect on your military experience, and they refer to that.
If you’ve got anger and resentment about how you left the military, you’re more likely to be struggling with some mental health issues there. It’s about the perceptions of civilians, and also about how flexible you are to take on different opinions. That’s about being regimented or not. They find that those that are more strict and regimented might struggle on the outside. Looking at exactly why people are struggling, the ones that are doing well, why they are doing well, and trying to get there in there early. We should be doing this type of stuff, having these types of conversations before people actually discharge.
As you pointed out, if that regimentality is a key factor, that is something that’s rewarded in the military. That is something that’s normally associated in your mind with positive effects. The more regimented, orderly, and organized you are, the more responsive you are to the institution, and what it asks of you to do, then that’s viewed as a positive. If you tend to leave the military and carry that regimentality, it makes sense why it would be difficult to find ways in a world that is seemingly so disorganised, which it’s obviously not, but coming from a very organised tribe that tells you that at 7:30 you’re doing physical training.
You don’t have to think about what you’re going to wear. You wear the uniform, very hierarchical organisation, you know who’s who in the zoo, and who you need to address in which way, and all that stuff. It makes absolute sense that this would be a challenge. I want to touch on perhaps the last key topic, and that’s how the organisation you’re with right now, Open Arms, supports treatment. Maybe you can give us a clear explanation as to what Open Arms actually does.
I’m happy to do that. I’m also happy to talk about how you treat PTSD, but I can do that in layman’s terms. I feel that people would not be quite confident or sure. If you see a psychologist and it’s to do with a trauma experience yourself, you’re not sure what to expect at all. Is it going to be like Freud, where they lie you down on a couch and ask you about where you’re breastfed by your mother? It’s not my experience of psychology at all.
That’s part of the false narrative that exists about psychology.
I thought I might talk about that. It’s in relation to trauma specifically. This is how I explain it when I have a client that first comes in and we talk about what we’re going to do. Going through traumatic events, your brain is a filing cabinet, something terrible that occurs, and you’re in shock. It’s almost like the filing cabinet is blown up and the files are all over the ground. What psychology assists with is picking up the files one-by-one, looking through them, getting a sense of what they are, and what they mean to you, and then putting them in an ordered state back into the filing cabinet.
With things like Exposure Therapy, it’s based on what we want to get to so that people aren’t triggered as often, or they know what it is that does trigger them, and they can quickly put in some coping strategies. What we want over time is not to be so reactive, hypervigilant, or have such a distressed reaction to things because you habituate to them. You’re exposed to it, and you get a sense of why you are reacting that way. Hopefully, the symptoms won’t be as extreme over time.
Clients often talk about just the anxiety and fear of being out of control. They’ll talk about, “I completely overreacted, and I have no idea why I did that,” and then remorse over some behaviour. Talking to a psychologist is trying to work out, “Let’s work out between us. Why did you do that?” It’s probably likely, what was it about that situation? “This is good. We’re getting some information here. We know that in these types of things and situations, you act a certain way. What’s the first sign? We’re trying to get some insight here about the first sign you can pick up that you might be starting to act a certain way. Let’s put in some coping strategies so that you can still be in the situation and not have to avoid or run away from it, but you have more control.”
I feel that psychological interaction is looking at providing great insights into understanding why people are acting a certain way, and then having a greater sense of control, “Things happen, I know how I act. I also know what to do about it to get that better sense of control.” That’s how I would explain the benefits I believe of going to see a psychologist in experienced trauma issues.
If I understand you correctly, the way that sums up in my head, it’s almost making the unconscious conscious. Oftentimes, we have these responses, or not oftentimes, we react and oftentimes, we’re not aware as to what the trigger was. What made me do that? Like the example you cited of, “I have no idea what made me do that.” That’s all of these unconscious things that are happening both in mind and the body that we’re not consciously aware of. Perhaps part of treatment is bringing that to light and unpacking that to create a link, “This is what my mind and my body are doing that I’m not conscious of at the moment.” Would that be accurate?
Yeah, that’s a good summary of it. It’s to gain that insight like know thy self. The better or greater insight people have helps generate a sense of control. With our sense of control, there should be less anxiety about it. I often hear it can be frightening for people. They went completely berserk or had no idea. They’re always anxious because to them, it seems like they could fly off the handle at any point. When you start speaking to a psychologist, there are usually very strong themes in why people are behaving a certain way or in certain environments. Gaining that insight means they’re able to have more control and should decrease anxiety then.
Is that maybe why meditation, as a practice, has shown to be quite effective in managing anxiety and stress, and to an extent, at least some research that I’ve read, on PTSD? Because it is about the insights and understanding of how the chattering mind, how powerful it can be when it runs freely and has the ability to impact the rest of the body. Do you have any insights on that?
I’m referring to it as a chattering mind. You’ve also referred to it as things are almost very fast and automatic, and the point is to slow it down. Instead of saying to someone that you’re feeling very sad, but you have no idea. When you speak to a psychologist, we’ll slow it all down and have a look at the self-talk, which we’re not aware of every single thought we have in our head. If you slow it down and you’re talking to a psychologist about it, what we often find for those that are depressed, for example, a lot of their self-talk is incredibly negative. The chattering mind is constantly putting themselves down.
What we’re trying to do is slow that down, capture those thoughts, and change them so that they’re more realistic. They’re not so negative and harmful to the person. You can see with someone with anxiety, when you slow down their thoughts, a lot of them are very panicked and catastrophising. If we’re able to slow those down, capture them, and then reflect and say, “What’s a more realistic response to this?”
That resonates with me. As a meditator, that makes sense because the whole point of meditation is to sit back and let the chattering mind do what it needs to do, without letting those thoughts take hold of you and carry you. In other words, that’s negative self-talk where you start having a go at yourself and your heart rate goes up. The next thing you know, one thing leads to another.
Whereas the whole idea of meditation, the practice, is all about sitting still and letting the mind do what it needs to do, but not getting attached to the mind. Realising that thoughts arise, they come, and they pass away. They don’t need to have the power over you as they have, oftentimes, particularly for any of us who are feeling any stress or anxiety. That actually resonated with me. Going back to Open Arms, what services do you offer?
Open Arms is originally founded by Vietnam veterans. We started off doing the counselling. We used to be called VVCS, Vietnam Veterans Counselling Service. The focus was providing psychological therapy for veterans. Since then, we’ve expanded both in eligibility and also the services that we provide. As I said beforehand, it’s not just about the individual. We know that we’re part of society. We’re also part of a family network as well. We’ve expanded eligibility. It’s for partners and families as well.
Not only doing individual therapy, we do couples therapy, and family therapy. There are other areas that we work on, which is, for example, clinical care coordination. It might not just be the mental health issues, but what else is impacting the veteran and their family. Often, it’s things like accommodation, finances, career, and general well-being and health. Our clinical care coordinators bring all of those things together.
Another area that we’ve more expanded into, which I’m very passionate about this, is the concept of a peer. It can be quite daunting for people to actually make an appointment to go and see a psychologist, particularly if they think it’s going to rock up and see someone like Freud. What we have are people that have a lived experience of being in the military. They’re a veteran themselves, and they’ve got some mental health training, but they are not a mental health professional like a psychologist. Their roles are a little bit different. It is that support. They talk about walking alongside someone.
It might be less daunting to go and see someone that has transitioned or deployed, and has gone through their own mental health issues and popped out on the other side. We find that’s very useful. You can see we all work in a multidisciplinary team. You might have a psychologist or a social worker working alongside a peer as well.
What’s good about this is we need a wide range of options to treat mental health. What fits for someone doesn’t fit for others. Gone are the days when the only way to address mental health symptoms is to go and see a psychologist. As I said, there’s a whole range. We do group programs as well, which are useful for those that enjoy that group atmosphere, sitting in a room with other people that have similar symptoms, and going through the treatment or education on suicide prevention, for example. Quite large eligibility and also a huge range of ways that we support mental health.There must be a wide range of options to treat mental health. What fits for someone doesn’t fit for others. Gone are the days when the only way to do this is by seeing a psychologist. Click To Tweet
I love the language of peer rather than the more traditional mentor-sponsor, which all of those imply a level of hierarchy. Whereas peer, that struck me as so powerful. This is somebody who is off my status, who’s equal to me. This is not me going to whinge about my life to someone. This is not me asking for professional help, which all of those things are hugely important, but also have an emotional load. They’re emotionally taxing. Whereas speaking to a peer, it’s someone like me who’s been through what I’ve been through. That’s spot on. The moment you said the program, that’s the name, that struck me. That was a very conscious choice. What was the reason behind that name?
You’ve summarised it. There is no hierarchy and judgment there. What we found that people are appreciating is speaking to someone, and that’s the beauty of lived experience who has been through something similar. When they say things like, “I know how you feel,” which you should never say as a psychologist, for example, but a peer may be in a better position to be able to do that because they’ve had similar experiences. They’ve deployed. They’ve gone through a transition.
I saw it. It struck me. We had a serving client that was at risk of suicide whilst they were at one of our office spaces. What we needed to do is get that person back to the base so that we could get them into their medical system, but we had to find out a way to get them back to the base. What I did was walk out, grab one of my peers, and they’re always so good with this, reacting on the spot, and asking if they would drive this client back to the base. You can see they’re not doing a psychological intervention, but that’s that walk alongside. It’s being someone who’s calming, understands. As someone said, “Peers aren’t taxi drivers,” and that’s not what I’m referring to. It was that feeling of support and non-judgment.
It’s being there for them.
It was a young man that was in crisis at the time, and my peer was an older Army here. It’s instant rapport with that lived experience. The peer walked in and was like, “I’m such and such. I’m here to drive you to the base. How are you going?” In a relaxed manner. Even with the age difference, there was instant rapport, but it almost felt you saw the relief on the younger man’s face. It honestly felt like dad was here to pick you up from school. It was the relief, an instant rapport. That’s the beauty of the peer team.
I notice that, being ex-serving, if I go to meetings and refer to the fact that I’m ex-Army, there’s always someone in this space that is as well. You’re almost friends immediately or this person’s going to be okay. I can trust them. The veteran community is incredibly supportive. You do see that instant, “I can trust you,” is one of those things if you are ex-serving and someone else is. That’s what that peer program leans on. As I’ve said, I’ve seen it work instantly and very well.
That’s beautiful, Pip. That got me that story. That’s powerful. It speaks to a lot of the themes that we’ve talked about. Intuitively, it makes sense. This person is from my tribe. They can immediately identify what I’m going through. How do you recruit people into that program, as in to be peers?
It’s a very popular program. We went to recruit for our Ipswich office. We only had one position there. We had over 33 applicants. What’s positive about that is people want to be involved in this role. It’s impressive. There are ex-serving members that want to go out and be able to support others. What do we look for in those roles? The lived experience, as serving military member, and also the experience of having a mental health issue, but being to the stage where they’re able to manage that and are quite stable themselves. They’re able to provide support to others. It’s two-pronged. They understand the military because they used to be in it, and they also know what it’s like to experience a mental health disorder.
That’s a powerful mix. It’s relevant to the circumstances that it’s designed to support. Well done for that program. Do people you recruited end up working there, or are these voluntary positions?
They end up working as part of Open Arms. We also provide mental health training for them. They’re part of the team. They’re part of a bigger peer team, but the important thing is, and that’s where I see our real value is when we work as a multidisciplinary team. Those peers might be working, they might have the same client as a psychologist, but you see they’re supporting the same person in a different way. They’re very much part of the team at Open Arms.
That’s also interesting, Pip. One area that we haven’t touched so far, and that is the impact on families. When we started our conversation, you said that part of what motivated you to join the military but also to get into psychology was certainly the experiences you’ve had as an Army brat, as you refer to it. How important are our families to support our veterans, but also how important is the support for families?
Protective families are factors for veterans. Often, people don’t actually go out to get psychological care until they’re in an absolute crisis. The day-to-day stuff, who they’re speaking to, who they’re disclosing things to, it’s often their partner and family members. They’re the front line in the support to veterans and mental health issues.
Alongside that though, you can imagine the day-to-day efforts in providing that support has an impact on them as well. That’s why Open Arms expanded our eligibility for partners and children because it’s recognising the impact that a partner or a parent service in the military can have on you as the child or the partner. There’s a range of things with this. We know with military families, they say one person joins, but the family serves, and that there are impacts on long-term careers or partners. The constant moving as well and the impact that has on children changing schools frequently.With military families, one person joins but the entire family serves. Their services have an impact on their long-term careers or partners. Click To Tweet
We can see that down the line as well. The statistics do show that, particularly for the adult children of current and ex-serving veterans, they tend to describe much greater psychological stress than the matched for age and gender in the population. We can see that military service does have an impact on the family, and that’s why we’re focused. It’s the year of the family and recognising the impacts it has on them, but also recognising the value and the effort they put into that day-to-day support to veterans.
It makes absolute sense why that is an important aspect. One of my previous guests, Brendan Cox, who heads up Legacy Brisbane, he’s also expressed the importance of that. Legacy, in particular, pays attention to families. What are some of those things that you are finding you can be most helpful with for families?
Family therapy actually is in great demand at the moment, which is a positive thing, and couples’ therapy. When we look at our service delivery statistics for Open Arms, there’s a huge spike in the need for that family therapy, which I think is important. For any mental health issue, it’s important to catch those early. I always have a pleasant reaction when I’m working in the office. You can hear very young children laughing in the corridors that we’re getting in there so early. We’re providing support to them when they’re quite young, rather than this avoidance of it and dealing with it down the track. It’s incredibly important to be able to provide those, couples’ therapy and family therapy support.
That’s hugely powerful and important. The impact of service, the way you phrased it, it’s the family that serves. I like that. Maybe I can ask a few more personal questions. Looking back on your extensive military career and working in a particularly sensitive area of dealing with the hardest. As in the people that are going out on the front lines and on deployments and experiencing extreme trauma, ultimately, you and your teams see the worst of war. You only are called upon to support that bad stuff. How do you look after yourself?
That’s a good question. I’m glad you asked it because I’ll often be asked, “Who psychs the psych?” To be honest, when working in some of these extreme situations, I didn’t feel that I was supported or supervised as much as I could have been, but what I relied on was my peers. It was the padre. It was the doctor. We might be seeing the same client but in very different ways. It’s important because, you know how we’re talking about the response to coping with trauma, that social support and networks are so important. It’s to be very much aware where to go out and seek that support from people that truly understand because they’re going through the same thing.
That’s what got me through when I was on the ground overseas. I had some issues myself with vicarious trauma. I was doing quite a bit of nightmare work with clients, and then I got to the stage where I started having their nightmares. That’s not too unusual. You can imagine if you’re doing that day in, day out, going through people’s horrible nightmares, that can stick with you as well. I got support myself to get through that, and thankfully, that wasn’t a long-term thing.
Working in this space with trauma, you’ve got to make sure that you are looking after yourself. That’s even that simple stuff like you’re eating well, that you are exercising regularly, and that you’ve got joy in your life. It’s something outside of what can be quite an intense and dark space. That’s useful as well. You’ve got to be very careful with your boundaries.
I get asked as well, “How do you talk about this stuff all day with people and then go home and sleep at night?” It’s about learning over time, and it’s difficult. You learn fast when you’re a junior. You have to be able to have that boundary up to be able to switch off as you get in your car to go home and not to keep ruminating over certain clients. That’s a very important skill to have as well.
It’s got to be tough to do as well. In many ways, it equally gives you a lived experience because you have to ultimately apply all the various tools that you are asking your clients or helping your clients to apply, which again makes you undoubtedly very qualified to be dealing with these issues. The more experience you have, the more you’ve had to deal with it. That’s an interesting dynamic.
Again, looking back on your career, when you think of your 17, 18 years of service, what stands out? What are some of the standouts? You mentioned your 2010 Afghanistan deployment, but are there any particular moments that you think would be either negative or positive that are the wavetops or the pillars of your experiences across all those years?
The deployments naturally stand out. Resilience is the word we throw around a lot. When you see it in crisis on the ground, it makes your jaw drop. Also witnessing in line with the incredible leadership skills of, at the time, very young individuals. I remember I’ve got fond memories of a lance corporal coming in and seeing me. This was when I was over in Afghanistan, and we had our session.
At the end of it, he said, “That was great, ma’am. I don’t mean to be rude, but I was just checking out, to be honest, if you’re a dickhead or not, but you seem pretty good. You’ve passed the test. I want you to see all of my guys,” and so what he had lining out the corridor, I didn’t know about, was his team. I thought that was sweet. That’s good leadership on his behalf.
It’s good he went in to see if I was worth the time or not before he exposed his team to it. He was also very much aware of being proactive and getting mental health support to his team. In fact, because they would only come back in to touch base, and then he had organised it every time they touch base, they have to come in and speak to the psych. I thought that was amazing leadership, at the time. Looking back also, some of the stuff that people were exposed to, not only were they able to deal with it, but how much support they gave to others.
Compassionate leadership is an area that I’m interested in because that’s what I saw and was getting everyone through. Those that not just leadership that showed compassion and were authentic, in a situation that didn’t avoid talking about what’s happened, the horrible event that acknowledged it, and was also understanding of quite extreme responses from people when something like this happens.
You see all these things that you read in books about resilience or the importance of morale, leadership, and cohesion. When there’s a crisis on the ground, and to actually see when it’s good for it all to come together, that’s how we survive. I’m talking about we, it’s that tribe again. You feel we’re all in this together, and we’re going to get through it. Those are the memories that I reflect fondly on.When there's a crisis on the ground, find out how it can be good for all. That's how humans survive. Click To Tweet
No one will tell you the truth as quickly, rapidly, and openly as soldiers will.
I even shook his hand when he said that.
What a compliment. I mean that in the most genuine way. That’s pure, raw honesty, and that’s fantastic. Pip, on that note, you have been very gracious with your time. We’ve gone somewhat beyond our great time. It’s been an absolute pleasure. I want to thank you for all the work you have done in military service and the work you continue to do as part of Open Arms, which is also a service to the veterans and their families. There is so much more that we could unpack areas that we can go into. I certainly hope that we’ll get a chance to pick up this conversation again in the future. It’s been an absolute pleasure.
Thank you so much.