Helping Veterans Navigate the Dual Systems Paradigm of Returning Home to Families Through Being with Their Experience and Letting the Connection Determine the Treatment Modality, Rather Than a Protocol

In this episode, Keith talks about his unique experience of being deployed in Iraq with his wife, and after a roadside bomb (IED) attack, she struggled with PTSD. He discussed how after she received treatment through the military mental health system, which was retraumatizing, he started taking classes in Psychology and learned all he could about trauma, and together they worked through her PTSD. This lead him to go on to obtain a doctorate in psychology, and work with veterans and their families specializing in combat trauma and military sexual trauma. He explained that soldiers are trained to turn all of their vulnerable emotions into aggression, because that is what is needed to survive in battle, and this makes it difficult for soldiers to transition back into their family system and larger society. Additionally, in the military, they form strong bonds with their fellow soldiers, and between conditioning, the group think, and the experiences that the soldiers go through together, it makes some feel that no one else understands their struggle which leads to suffering alone. This creates a dual family systems paradigm, the differences between the military system’s culture and the family’s system’s culture, leaving veteran's feeling disconnected from both families. He discussed the importance of connecting with the individual, being with their experience, and how this can be very hard for clinicians as working with veterans with trauma session after session can lead to vicarious trauma and compassion fatigue. He discussed his work with The Hume Center, with the chronically homeless population and working with severe mental illness, and how there is a great deal of intersectionality between homelessness and veterans. He discussed the importance of meeting the client where they are, and then finding what approaches might fit best for them, rather than using a top down approach such as trying to fit them into an evidence based scripted protocol. We discussed a rather successful program for Veterans in Oakland at the Oakland Vet Center, where staff had been working there for many years, as opposed to other programs where there is high turnover both in clients and in clinicians. One of the aspects that seemed to make it successful was the connections built through the community of clients. He discussed how clients who had been doing group work there would come to his PTSD 101 workshops just to see their friends. We discussed how engagement, whether with the clinician, or the community of clients was so significant in engagement for mental health services. ​Keith Bonnes, Psy.D. is a clinical psychologist and an Air Force (deployed Army) blue to green veteran of the Iraq war. Keith has worked extensively with veterans and their families and now works at The Hume Center in the San Francisco Bay Area East Bay https://www.humecenter.org, which as a Non-profit provides a range of community based treatments including full service partnership with homeless individuals, outpatient services and partial hospitalization programs and many other community based services and programs. He is also a trainer with The Hume Center working to help develop the clinical skills of early career clinical trainees and provide an exceptional training experience as a behavioral training center. He works from a humanistic, client centered, phenomenological approach, meeting the client where they are, and connecting with their experience, and then integrating modalities of treatment and interventions to fit for the clients perspective of the world. Keith uses Maslow’s Hierarchy of Needs as a building principal along with cultural humility in his work with clients to ensure a holistic approach to the clients experience is considered.