The implications of counterfactual thoughts on military members and veterans

Abstract

While there is a plethora of research conducted on therapeutic techniques for military service members and veterans with Post-Traumatic Stress Disorder (PTSD), there is little information about how certain cognitive processes may hinder participation in therapy or various mental health interventions. There remains a large problem within the military, in that many returning military service members and veterans are not seeking services when they need them. The cognitive mechanism of counterfactual thinking may play a role in hindering the treatment seeking process for service members and veterans. Counterfactual thinking has been defined as “mental representations of alternatives to the past.” Usually elicited by negative events, counterfactual thinking is produced when an individual creates hypothetical alternatives to their previous actions resulting in a different, hypothetical outcome. This graduate master’s thesis sought to explore if using different kinds of counterfactual thinking mechanisms can impact a military service member or veteran’s stigma against seeking psychological treatment and resulting meaning surrounding their military life. Findings show that there were no significant differences in different types of counterfactual thoughts on one’s internalized stigma of seeking help, or one’s meaning making. However, there may be changes in how counterfactuals are used regarding the intensity of one’s experiences within the military, and the intensity of their PTSD and depression symptoms. Implications of using counterfactual thoughts to reduce barriers to help-seeking are also discussed.