Family Filmmaking: A Creative, Collaborative Approach to PTSD

Multiple IED blasts didn't kill Navy demolitions expert John Muchetti. But the lesions they left on his brain today cause epileptic-like symptoms including psychotic episodes, slurred speech, loss of balance, and passing out. John was medically retired from the service in early 2015 after seven deployments on three continents clearing booby traps and land mines in hostile areas. He was parted from his wife and children for 10 months of each year for almost a decade. His final return home didn't end his battles. "I felt like a step-parent," John says today, "Inserting myself into this group of strangers. It was emasculating and awful."

Reintegrating into civilian life after adapting to war is no easy feat for any soldier. An estimated 20% or 500,000 of the veterans who deployed to Iraq or Afghanistan meet the criteria for PTSD, and its effects can impact their entire family (Peterson, Luethke, Borah, Borah & Young-McCaughan, 2011). When it comes to the family unit, war injures everyone. Sadly, there are few viable mental health services for the families of service members, and healing together is a formidable challenge. Despite trying therapies offered by the VA, John found himself distanced from a family that could not relate to his "new norm." This isolation on top of his serious injuries was particularly cruel--for both John and those who love him.

As the creator of I Was There Film Workshops, I have had the honor of working with hundreds of veterans in transition. I Was There provides week-long free, therapeutic filmmaking workshops for active-duty and retired veterans coping with posttraumatic stress disorder (PTSD) and other forms of service-related stress. Our instructors give veterans a crash course in digital filmmaking basics and help them craft short, collaborative films about their service. I have seen veterans from different branches and eras of military service who had never met before unite with a new mission. Within just a few days, they share ideas and produce intensely personal short films expressing experiences that are difficult and often impossible to communicate conventionally, even (perhaps especially) to their own families. Our follow-up surveys indicate an almost 20% drop in PTSD symptoms among participants upon completion of the workshop. Many say the experience allowed them to move forward in their transition to civilian life, including pursuing ongoing mental health care. Family members of IWT participants often tell us that the workshop changed their lives, facilitating communication and understanding across gaps that had previously seemed impossible to bridge. Families that had been broken apart began to heal together.

Based on feedback from hundreds of veterans who have participated in I Was There workshops, we held our first workshop for entire military families in the fall of 2014. John Muchetti, along with wife, Kelly, and their two young children Haven, 12, and Archer, 9, were in attendance.

Over the course of the workshop, it became clear that this family had survived
long stretches of separation by not sharing their difficulties. This silence was well-intentioned. The family members wanted to protect one another. Haven confessed that when Skyping with her father, she would not to tell him how worried she was, afraid this upsetting information might endanger him in battle. Instead, "Every single night I said my prayers, telling myself that my daddy was brave and strong and would come home safely."

Likewise, John would rarely tell his family details of dangerous and stressful things going on, hoping they wouldn't worry as much. While this coping mechanism may have its merits during wartime, it does not help the family once a veteran returns home.

"It was really stressful," said John's wife, Kelly. "On one hand, we were so happy to have him back. [But] we could tell something was not right. So the kids and I were kind of standoffish." After so many years of having John home only for limited, "honeymoon" periods, the family was unclear on how to live with John as a permanent resident again.

"He was home for the delivery of both kids and then left," Kelly said. "When [the kids] had temper tantrums or were hungry, he had no idea what to do" Trying to be a good mother and supportive wife to a seriously injured husband took a grave toll on Kelly, and her relationship with John. The kids, meanwhile, saw their dad as frightening and unpredictable, a near-stranger. "We kept everything kind of polite and surface-y"

"If John was getting angry or the kids were upsetting him, we didn't talk about [it]," Kelly said. She and the kids knew not to ask "What's wrong with daddy? Why is he so mad? We wanted to diffuse the situation rather than have everything blow up. 'Pass the salt' was about all we discussed. We went to counseling, but all we ever spoke about was his job and its stresses. The rest of us would just sit there, it was very frustrating. The therapy was always from his perspective, not from the family as a whole."

Then, the Muchettis entered the family workshop, a space specifically designed to foster collaboration and dialogue. "When we went to the workshop and recorded things [about how we felt] for the film--that was the first time John had ever heard those things," said Kelly. "He finally saw things from another perspective." The role of instructors and other participants as witnesses to this journey--listening empathically and non-judgmentally--promotes healing. The engagement of other veterans is crucial because their narratives validate and reinforce one another's. A similar dynamic arises among different families dealing with similar issues. In this supportive context, working together to produce a short film allowed the Muchettis to have honest discussions with one another that, John says, "We had never, ever had since I went to war."

There are myriad programs designed to help veterans recover, and different approaches work for different people. Popular and often effective therapies, such as Prolonged Exposure Therapy (PET) and Cognitive Processing Therapy (CPT), involve narrative in the form of a patient recounting or re-experiencing an event over and over again until they become more comfortable with it. Our filmmaking approach also involves narrative, but our workshops put veterans and families in of control of the process and its tools. They choose whether and how to engage with traumatic experiences, a crucial difference for veterans unproductively re-traumatized by PET or CPT. While therapeutic, our workshops are not therapy sessions, and crucially don't involve sitting in the hot seat of a doctor's office--something many participants avoid because of fear, stigma, and/or past negative experiences. Indeed, as many as half of veterans with PTSD or depression seek no therapeutic help at all for these very reasons (Tanielian & Jaycox, 2008).

While the VA strongly emphasizes PET and CPT over other forms of therapy for PTSD, it acknowledges that these evidence-based approaches don't always suit everyone. The VA recently put out a request for proposals for an Industry Innovation Competition inviting new, "non-therapy" approaches to help veterans coping with mental illness. But time is of the essence and we cannot wait. According to the VA, twenty-two veterans commit suicide each day (Stewart, 2013). There is a clear, dire need for mental health care that is not being met. Whether it's our emerging field of therapeutic filmmaking, other forms of expressive art therapy, or transcendental meditation, research indicates that alternative therapies can be absolute lifesavers for veterans and military families in crisis. We must make these tools accessible now, before the next preventable tragedy.

The Muchettis credit I Was There's alternative approach with allowing their family to re-encounter one another and truly begin communicating. Things aren't perfect. But they've become a trusting, talkative and genuinely supportive household again. John and Kelly are in couples counseling and the family also sees a new group counselor. John is pursuing a career as an art therapist. John and Kelly recently returned to the I Was There classroom, driving almost 300 miles from North Carolina to New York City to mentor at a workshop for individual vets. They presented their family's film and took questions from participants about how to maintain or rebuild relationships upon returning from war. A constant theme, both here and at all IWT workshops, was the devastating impact of deployment not only on service members, but on those they love. Family members may try to hide it, most service members are well aware of--and torn apart--the toll their service has taken on those they love most. "What I always tell combat veterans is that these feelings do not deserve to own you, and you cannot allow them to," said John.

Tens of thousands of veterans are currently in transition, many returning to families stressed by the past and unprepared for the future. Every avenue to help returning vets and their families must be explored and put into action, including non-traditional therapeutic pathways such as collaborative filmmaking. All of our countrymen deserve the healthy homecoming that the Muchettis achieved together.

Benjamin Patton is founder and executive director of the Patton Veterans Project, which sponsors the therapeutic I Was There Films Workshops program for veterans. He is the youngest grandson of WWII's General George S. Patton, Jr. and author of "Growing Up Patton" (Berkley-Caliber 2012).

Peterson, A. L., Luethke, C. A., Borah, E., Borah, A., & Young-McCaughan, S. (2011). Assessment and treatment of combat related PTSD. Journal of Clinical Psychology in Medical Settings, 18(2), 164-175. doi:10.1007/s10880-011-9238-3.

Tanielian, T., & Jaycox, L. H. (Eds.). (2008). Invisible wounds of war psychological and cognitive injuries, their consequences, and services to assist recovery. Retrieved from http://www.rand.org/ . Elbogen et al., 2013).

Elbogen, E. B., Wagner, H. R., Johnson, S. C., Kinneer, P., Kang, H., Vasterling, J. J., ... & Beckham, J. C. (2014). Are Iraq and Afghanistan veterans using mental health services? New data from a national random-sample survey. Psychiatric Services.

Stewart, P., & Cooney, P. (2013, February 1). U.S. military veteran suicides rise, one dies every 65 minutes. Retrieved October 27, 2015, from http://www.reuters.com/article/2013/02/02/us-usa-veterans-suicide-idUSBRE9101E320130202