Combat trauma and PTSD may create risk for Intimate Partner Violence in military families. 

Transitioning out of the military can be a stressful period as veterans learn to re-adapt to the financial, social and other unforeseen challenges of civilian life. What’s more, the trauma of combat can often have negative effects on servicemen and women who are struggling to adjust to life outside of the military.

As a U.S. combat veteran, Clinical Associate Professor Michael Rank is affiliated with the school's Military and Veterans Programs, which houses the USC Center for Innovation and Research on Veterans & Military Families. His expertise covers military social work, PTSD and veterans’ issues. He has spent much of his career working in advocacy programs for military-affiliated individuals, where he gained experience addressing the issue of domestic violence within military families. In this Q&A, he shares what he’s learned about the causes, treatment approaches and tactics for addressing this issue among veterans.

USC Suzanne Dworak-Peck School of Social Work: What sparked your interest in studying the connection between PTSD and domestic violence in military families?

Michael Rank: I served in the Vietnam War in the 1970s, and my experience in the military directed the rest of my professional life. Though I didn’t suffer from PTSD, I was aware of the trauma that followed me when I left the military. As such, I’ve maintained an interest in the traumatic stress sustained from warfare and how it can impact readjustment to civilian life.

I worked in the U.S. Department of Veterans Affairs at the Savannah Vet Center in Georgia, and later began directing clinical advocacy programs for Air Force service members and their families—some of whom had experienced domestic violence. 

USC: What are some of the factors that may contribute to the increased prevalence of domestic violence among service members and veterans?

MR: While of course nothing excuses or justifies violence toward others, a number of factors may put service members at higher risk. Rates of violence in military families may be closely linked to lasting trauma, which can manifest as PTSD or subclinical PTSD—a condition that presents with nearly all of the symptoms associated with PTSD, but without the official diagnosis.

In the military, combat service members are trained in highly specialized defense and survival tactics that dictate how they respond to certain stressors and perceived threats. As a result, when they return home, they are sometimes unable to react appropriately to stress. If a service member or veteran perceives a threat within their home, they may be prone to reacting aggressively out of instinct. Additional factors, such as substance abuse problems, depression or psychological disorders may put a service member or veteran at higher risk.

USC: What do you see as an effective model of treatment?

MR: I believe each situation should be handled on a case-by-case basis, since every family situation is unique. Sometimes a family will see amazing results after the individual undergoes anger management classes. Other cases require continuous effort to help a veteran reassimilate to the civilian world.

If possible, I believe that the best way to start addressing a domestic violence case involves speaking to both parties together in an initial meeting. This sets a precedent of trust, since the clinician is not meant to be on one side or the other, but rather to help the family work together toward a shared goal.

Establishing this shared goal is a critical first step. Often, couples with relationship issues come to me and one of the two is already mentally checked out of the relationship—in which case healing can never be fully effective. During my time working on the Air Force base, I required patients to agree upon and vocalize their commitment to one another, and create a shared vision for what their partnership would look like a year down the road. I also asked that they commit to the entire process without the possibility of quitting.

I also think it’s critical to meet with both parties one-on-one at different points throughout the process. Understandably, each party may sometimes be reticent to speak up when they are around their partner. It’s important to uphold a policy of confidentiality that includes everything except information that a therapist or social worker is required to report to authorities.

USC: What preventative measures can be taken to reduce the risk of violence?

MR: I believe that to mitigate aggression and poor outcomes for veterans and their loved ones, the military needs more family advocacy programs as well as a more comprehensive desensitization protocol. Desensitization is a type of therapy that seeks to decrease fear and other negative emotional responses to a phobia or an aversive stimulus. A systemic approach to desensitization can help service members lead more normal, healthy social lives. 

The best thing we can do is to continue to educate—not simply to raise awareness, but to provide tactical training that can be applied in stressful, high-risk situations. I want to provide veterans with more resources that can help them learn how to regulate their emotions and how to react when they feel anger or fear. Ultimately, it’s about providing more structural support to ease the stress, trauma and emotional disconnection experienced by service members returning from combat so that they can engage in healthy relationships with their partners and families.