Last Saturday, I went to Miami, Florida, at the invitation of Paula Lalinde (see her profile at http://www.linkedin.com/pub/paula-lalinde/11/677/a12) to attend MILITARY 101: Military Life and Combat Trauma As Seen By Troops, Their Families, and Clinicians. This day-long free presentation was sponsored by The Veterans Project of South Florida-SOFAR, in association with The Southeast Florida Association for Psychoanalytic Psychology, The Florida Psychoanalytic Society, the Soldiers & Veterans Initiative, and the Florida BRAIVE Fund. The goals of the session “included increased understanding of the unique experiences and culture related to the military experience during wartime, enhanced understanding of the assessment and treatment of trauma specific difficulties, including posttraumatic stress disorder, common co-occurring conditions, and demands of treatment on trauma clinicians.”
Listening to the speakers on Saturday morning at the Military 101 orientation, I was struck by what seemed to me to be a developmental trajectory implied in the construct of therapy-aided healing. I don’t recall if anyone explicitly mentioned Maslow’s hierarchy but it was certainly implied by the dysfunctionality that attends being pushed down to a basic mode of physical survival.
Also, the various references to the stigma of therapy reminded me of Paula’s arguments as to why a community-based preventative approach would be more accessible and likely more successful than individual programs focused on treating problems. (Echoes here of positive psychology and appreciative inquiry.)
In one part of the program, the ritualized formality of the soldier, family, and support groups’ stated promises to each other suggested a way of operationalizing the community-based approach. The expectations structuring relationships among the parties in this community are usually left largely unstated, unexamined, and unmanaged in all but the broadest, and most haphazard, ways (as most relationships’ expectations usually are). The hierarchy of needs and progressive movement towards greater self-actualization implies a developmental sequence of steps or stages that comprise the actual focus of the implied contracts between the members of the community. This sequence is a measurable continuum along which change can be monitored and managed, with all parties accountable for their contracted role in producing specific outcomes.
The process would begin from the predeployment baseline, taking that level of reliability and basis of trust existing in the community as what we want to maintain, what we might want to get back to, and what we definitely want to build on and surpass, in time. The contract would provide a black-and-white record of expectations. It would embody an image of the desired state of the relationships and it could be returned to repeatedly in communications and in visualizations over time. I’ll come back to this after describing the structure of the relational patterns we can expect to observe over the course of events.
The Saturday morning discussion made repeated reference to the role of chains in the combat experience: the chain of command, and the unit being a chain only as strong as its weakest link. The implication was that normal community life tolerates looser expectations, more informal associations, and involves more in the way of team interactions. The contrast between chains and teams brought to mind work by Wright (1995, 1996a, 1996b; Bainer, 1997) on the way the difficulties of the challenges we face influence how we organize ourselves into groups.
Chains tend to form when the challenge is very difficult and dangerous; here we have mountain climbers roped together, bucket brigades putting out fires, and people stretching out end-to-end over thin ice to rescue someone who’s fallen through. In combat, as was stressed repeatedly last Saturday, the chain is one requiring strict follow-through on orders and promises; lives are at risk and protecting them requires the most rigorous adherence to the most specific details in an operation.
Teams form when the challenge is not difficult and it is possible to coordinate a fluid response of partners whose roles shift in importance as the situation changes. Balls are passed and the lead is taken by each in turn, with others getting out of the way or providing supports that might be vitally important or merely convenient.
A third kind of group, packs, forms when the very nature of the problem is at issue; here, individuals take completely different approaches in an exploratory determination of what is at issue, and how it might be addressed. Examples include the Manhattan Project, for instance, where scientists following personal hunches went in their own directions looking for solutions to complex problems. Wolves and other hunting parties form packs when it is impossible to know where the game might be. And though the old joke says that the best place to look for lost keys is where there’s the most light, if you have others helping you, it’s best to split up and not be looking for them in the same place.
After identifying these three major forms of organization, Wright (1996b) saw that individual groups might transition to and from different modes of organization as the nature of the problem changed. For instance, a 19th-century wagon train of settlers heading through the American West might function well as a team when everyone feels safe traveling along with a cavalry detachment, the road is good, the weather is pleasant, and food and water are plentiful. Given vulnerability to attacks by Native Americans, storms, accidents, lack of game, and/or muddy, rutted roads, however, the team might shift toward a chain formation and circle the wagons, with a later return to the team formation after the danger has passed. In the worst case scenario, disaster breaks the chain into individuals scattered like a pack to fend for themselves, with the limited hope of possibly re-uniting at some later time as a chain or team.
In the current context of the military, it would seem that deployment fragments the team, with the soldier training for a position in the chain of command in which she or he will function as a strong link for the unit. The family and support network can continue to function together and separately as teams to some extent, but the stress may require intermittent chain forms of organization. Further, the separation of the soldier from the family and support would seem to approach a pack level of organization for the three groups taken as a whole.
An initial contract between the parties would describe the functioning of the team at the predeployment stage, recognize the imminent breaking up of the team into chains and packs, and visualize the day when the team would be reformed under conditions in which significant degrees of healing will be required to move out of the pack and chain formations. Perhaps there will be some need and means of countering the forcible boot camp enculturation with medicinal antidote therapies of equal but opposite force. Perhaps some elements of the boot camp experience could be safely modified without compromising the operational chain to set the stage for reintegrating the family and community team.
We would want to be able to draw qualitative information from all three groups as to the nature of their experiences at every stage. I think we would want to focus the information on descriptions of the extent to which each level in Maslow’s hierarchy is realized. This information would be used in the design of an assessment that would map out the changes over time, set up the evaluation framework, and guide interventions toward reforming the team. Given their experience with the healing process, the presenters from last Saturday have obvious capacities for an informed perspective on what’s needed here. And what we build with their input would then also plainly feed back into the kind of presentation they did.
There will likely be signature events in the process that will be used to trigger new additions to the contract, as when the consequences of deployment, trauma, loss, or return relative to Maslow’s hierarchy can be predicted. That is, the contract will be a living document that changes as goals are reached or as new challenges emerge.
This of course is all situated then within the context of measures calibrated and shared across the community to inform contracts, treatment, expectations, etc. following the general metrological principles I outline in my published work (see references).
The idea will be for the consistent production of predictable amounts of impact in the legally binding contractual relationships, such that the benefits produced in terms of individual functionality will attract investments from those in positions to employ those individuals, and from the wider society that wants to improve its overall level of mental health. One could imagine that counselors, social workers, and psychotherapists will sell social capital bonds at prices set by market forces on the basis of information analogous to the information currently available in financial markets, grocery stores, or auto sales lots. Instead of paying taxes, corporations would be required to have minimum levels of social capitalization. These levels might be set relative to the value the organization realizes from the services provided by public schools, hospitals, and governments relative to the production of an educated, motivated, healthy workforce able to get to work on public roads, able to drink public water, and living in a publicly maintained quality environment.
There will be a lot more to say on this latter piece, following up on previous blogs here that take up the topic. The contractual groundwork that sets up the binding obligations for formal agreements is the thought of the day that emerged last weekend at the session in Miami. Good stuff, long way to go, as always….
References
Bainer, D. (1997, Winter). A comparison of four models of group efforts and their implications for establishing educational partnerships. Journal of Research in Rural Education, 13(3), 143-152.
Fisher, W. P., Jr. (1995). Opportunism, a first step to inevitability? Rasch Measurement Transactions, 9(2), 426 [http://www.rasch.org/rmt/rmt92.htm].
Fisher, W. P., Jr. (1996, Winter). The Rasch alternative. Rasch Measurement Transactions, 9(4), 466-467 [http://www.rasch.org/rmt/rmt94.htm].
Fisher, W. P., Jr. (1997a). Physical disability construct convergence across instruments: Towards a universal metric. Journal of Outcome Measurement, 1(2), 87-113.
Fisher, W. P., Jr. (1997b, June). What scale-free measurement means to health outcomes research. Physical Medicine & Rehabilitation State of the Art Reviews, 11(2), 357-373.
Fisher, W. P., Jr. (1998). A research program for accountable and patient-centered health status measures. Journal of Outcome Measurement, 2(3), 222-239.
Fisher, W. P., Jr. (2000). Objectivity in psychosocial measurement: What, why, how. Journal of Outcome Measurement, 4(2), 527-563 [http://www.livingcapitalmetrics.com/images/WP_Fisher_Jr_2000.pdf].
Fisher, W. P., Jr. (2004, October). Meaning and method in the social sciences. Human Studies: A Journal for Philosophy and the Social Sciences, 27(4), 429-54.
Fisher, W. P., Jr. (2005). Daredevil barnstorming to the tipping point: New aspirations for the human sciences. Journal of Applied Measurement, 6(3), 173-9 [http://www.livingcapitalmetrics.com/images/FisherJAM05.pdf].
Fisher, W. P., Jr. (2008). Vanishing tricks and intellectualist condescension: Measurement, metrology, and the advancement of science. Rasch Measurement Transactions, 21(3), 1118-1121 [http://www.rasch.org/rmt/rmt213c.htm].
Fisher, W. P., Jr. (2009, November). Invariance and traceability for measures of human, social, and natural capital: Theory and application. Measurement (Elsevier), 42(9), 1278-1287.
Wright, B. D. (1995). Teams, packs, and chains. Rasch Measurement Transactions, 9(2), 432 [http://www.rasch.org/rmt/rmt92j.htm].
Wright, B. D. (1996a). Composition analysis: Teams, packs, chains. In G. Engelhard & M. Wilson (Eds.), Objective measurement: Theory into practice, Vol. 3 (pp. 241-264). Norwood, New Jersey: Ablex [http://www.rasch.org/memo67.htm].
Wright, B. D. (1996b). Pack to chain to team. Rasch Measurement Transactions, 10(2), 501 [http://www.rasch.org/rmt/rmt102s.htm].
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