You should not have to explain the job first.

You already know how this usually goes. You explain the structure, the deployment, the acronyms, what the job actually involved, and by the time the clinician has caught up the session is over and nothing has moved.

You will not have to do that here. I have worked with service members and veterans for years. I am not going to ask you to translate, and I am not going to react to things you say in a way that makes you manage me.

The parts that do not fit the civilian vocabulary

Some of what you are carrying does not sort neatly into a diagnosis. Missing it. Missing the competence, the clarity, the people. Being angry at how small and negotiable everything feels now. Having done things that were correct in context and do not stay correct at three in the morning.

Moral injury is not the same as fear-based trauma and it does not respond to the same approach. Neither does the plain grief of having been extremely good at something that no longer exists.

What we do about it

Direct work, on the things costing you the most, in whatever order you want them. For a lot of people that means sleep first, because everything else is harder to treat while you are running at five hours.

• Sleep, startle, and the physical residue, before anything else
• Anger that has become the only emotion with a clear channel
• EMDR for memories still behaving like present events
• The marriage or the family, if that is where it is landing
• Alcohol, if it has become the thing that makes the evening survivable

On EMDR

It is a structured protocol for reprocessing a specific memory, not a conversation about your childhood and not hypnosis. It is one of the better-evidenced approaches for combat trauma. It is also optional, and it works badly when someone has been talked into it.

What I am not

I do not work for the VA and this is not a disability evaluation. Nothing you say here becomes part of a claim, a fitness determination, or a command notification. I also do not write letters for court or for benefits. If that is what you need, say so on the first call and I will tell you where to go instead.

If you are in immediate danger or thinking about harming yourself, call or text 988, or call 911. The Colorado Crisis Line is 1-844-493-8255, or text TALK to 38255.