I spent two decades as an Army Behavioral Health Officer. During this time, I deployed to Iraq twice to work with soldiers on the ground. I am sadly familiar with the losses and devastation experienced by soldiers in combat.

The emotional reactions I’ve observed following this election season are similar to the range of expressions I’ve seen emitted in war. For those struggling to cope, I offer some cognitive therapy techniques which may be helpful for those coming to grips with our political changes.

The first thing I want to emphasize is that no one can label the mourning but the mourner.

If a client states they are sad/upset/angry that’s all that matters. A good therapist will reality test a situation, explore different perspectives, help identify goals necessary to move forward. These are all normal grief responses. We don’t tell someone to “get over it” or that there is no reason for sadness. That said, we also don’t give permission for unhealthy coping methods to include bullying, emotional abuse, acts of civil disobedience or harming others.

Here are some of the behaviors that can be problematic:

• Catastrophizing: When every thought is negative, and it builds to the worst case scenario. An example of this thought pattern in regards to the election, “Trump was elected, which means the Affordable Care Act will be repealed and my sister who has cancer won’t have health insurance and have to go to Mexico for treatment which she can’t afford.”The key to overcoming catastrophizing is making a distinction between something being significantly unpleasant and it being a catastrophe. Failing an important exam would be extremely upsetting, but it does not doom the individual to a life of failure. Remember there is always an opportunity for success.
• Rumination: When the topic keeps you awake at night.It is the looping soundtrack in your head that you can’t turn off.First things first, severely limit social media. I have friends who work themselves up into a frenzy over Facebook posts from those with opposing views. Turn it off for a designated period, especially if it fuels anger, anxiety or depression. Work on something that you enjoy that involves creation or building. Serve someone else. Read a book. Travel.
• Fortune Telling: One of the most common cognitive distortion, Fortune telling is a when you predict a negative outcome based on feelings or assumptions that some event or events will end badly for us. An example of this thinking is, “Now my neighbor who is here on a work visa will be deported.”Combat these by talking through these thoughts with someone who is objective and can tell you when you are spiraling downward in your thoughts. You can try this dialogue, “Is this reality or is this just my fear that this will happen?” When you notice fortune telling thinking respond with reality testing questions, such as, “do I know this is true? How do I know this will happen? What evidence is there to prove my point.” This may take a bit of practice to master but it is a skill easily self taught.
• Disqualifying the Positives: This is an inability to see any silver lining in a given situation. “I don’t care that Trump is a political outsider, he is a racist, xenophobic, misogynist and will never see the world the way I do.”Vet your news sources. There is so much from questionable or unreliable sources on the web, (” it’s on the internet so it must be true.”). Realize bias in sources for example; Fox news tends to be conservative; NPR tends to lean left; the Washington Times is a conservative viewpoint while the Washington Post is more liberal. Spend your energy researching what the politician said as opposed to the interpretation provided by the media at large. Practice looking at scenarios with the thought, “What is the best that can happen?” 

  Surround yourself with friends who have varied ideologies. Embrace diversity both socially and politically. It can be less adversarial to exchange ideas when you have a foundation of friendship.

  When it comes to racism and misogyny, practice assertive confrontation. Confront the behavior, not the person. Recognize that most who make these types of comments may not realize how their words are perceived. Be willing to engage in two-way conversations. Practice active listening techniques.

• All or Nothing Thinking: Things are either great or they’re terrible. “I might as well move to Canada now.” This perspective almost always leads to depression, isolation, and anxiety. To combat this; one must be flexible enough to see things in shades of gray. Now is the time to practice mindfulness. One of my favorite therapeutic books regarding fear is Pema Chodron’s, “Places That Scare You.” This book from a Buddhist perspective, helps your relax and change negative thought processes by embracing fear. We can let the circumstances of our lives harden us and make us increasingly resentful and afraid, or we can let them soften us and make us kinder.

These are some of the Cognitive Behavioral Therapy (CBT) techniques I used with my clients in Iraq. During my last deployment, I was the primary behavioral health provider for my Brigade of 4,000 and for the 1,000 additional soldiers, contractors and civilians we supported on our Forward Operating Base.. Although I am a therapist who is willing to employ a variety of therapeutic perspectives to meet my client’s needs, I found that in a combat environment, CBT was THE most effective tool for working with individuals experiencing great stress and personal sacrifice. In this time of great uncertainty and anxiety, I hope that this tutorial may make a positive impact on my fellow Americans.

*If you would like to read more about my work on my deployments in Iraq you can find it here…

gabrielle-marie-claire-june-2004- The Iraq War you Haven’t Heard About -originally published in Marie Claire in June 2004

Smoking Cessation In Iraq

Troops with Manageable Mental Health Problems Low on Pills– an article from my deployment in the beginning of the war

Caring for the Military: A Guide for Helping Professionals-Recent chapter written as a co-author with some colleagues

The Division Psychiatrist and Brigade Behavioral Health Officers– co-authored chapter in the Textbook of Military Medicine