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Intergenerational life review group with Canadian World War II veterans and Canadian peacekeepers Gervais, Deanne Marie 2001

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Intergenerational Life Review Group With Canadian World War II Veterans and Canadian Peacekeepers by Deanne Marie Gervais B.A., Simon Fraser University, 1990 A THESIS SUBMITTED FN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES Department of Educational and Counselling Psychology and Special Education WE ACCEPT THIS THESIS AS CONFORMING TO THE REQUIRED STANDARD THE UNIVERSITY OF BRITISH COLUMBIA March 2001 © Deanne Marie Gervais, 2001 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of tfLmtlMOil OfA fauXLltfij> ^[jM The University of British Columbia SfAuJ CCLU.0 Vancouver, Canada Date DE-6 (2/88) 11 A B S T R A C T The following research study was an ethnographic case study of an intergenerational life review/guided autobiography group consisting of four World War II veterans, five peacekeepers and one member who was a World War II veteran, a Korean veteran and a peacekeeper. The group members ranged in age from 30 to 82. Al l ten group members participated in a six week life review program (LRP) followed by an individual audio-taped interview. This interview was followed up by a validation interview. The purpose of this research was twofold. There were the research goals coupled with the goals, and intended benefits to, the participants. These goals and benefits often overlapped. The research goal was to answer four questions posed at the beginning of the study. They were: 1) What are the specific competencies, skills and knowledge needed for successful re-entry into civilian life? 2) Can these skills, competencies, and knowledge be successfully passed on in an intergenerational LRP involving both World War II veterans and peacekeepers? 3) Will the intergenerational passing on and receiving of these competencies, skills and knowledge lead to increased feelings of efficacy on iii the part of both World War II veterans and peacekeepers? 4) What changed for the individual during the course of the program and do they view their lives differently after the guided autobiography/life review experience? The goals, or intended benefits, to the participants were not formulated before the study but instead the method of grounded theory was employed. Grounded theory can be described as "a general methodology for developing theory that is grounded in data, systematically gathered and analyzed" (Strauss & Corbin, 1994, p. 278). Evidence emerged for two of Birren and Deutchman's (1991) seven outcomes. Those two outcomes were: 1) recognition of past adaptive strategies and application to current needs and problems and 2) development of friendships with other group members. Ten new outcomes were also identified. They were: 1) normalization of one's reactions to trauma or to events (e.g. re-entry); 2) the receipt of specific advice, ideas, or assistance; 3) engendering of hope; 4) relief or emotional release in telling one's story; 5) feeling heard/being listened to; 6) relating/commonality with others; 7) new awareness or heightened awareness of one's contributions and/or abilities; 8) new awareness or heightened awareness of others' contributions and/or abilities; 9) positive feelings obtained from others' responses to one's story; and 10) a new appreciation of one's life through comparison with other group members' lives. T A B L E O F C O N T E N T S iv Abstract ii Table of Contents iv Acknowledgments vii Chapter One - Introduction 1 Background to the Problem 1 Purpose of the Study 4 Significance of Study 7 Chapter Two - Literature Review 8 Parallels Between Soldiers 8 The Re-entry Process 12 Impact of Re-entry on Families 16 World War LI Veterans and Life Review 22 Life Review and Guided Autobiography 26 Chapter Three - Methodology 30 Research Design 30 Data Collection 31 Data Analysis 36 Participants 41 Demographics 42 Ethical Considerations 43 Limitations of the Study 44 Chapter Four - Results 46 Biographical Synopses 46 George's Biography 46 Robert's Biography 48 Gregory's Biography 50 Raymond's Biography 51 Taylor's Biography 53 Graeme's Biography 54 Reg's Biography 56 John's Biography 57 Jim's Biography 58 Scott's Biography 59 V Summary of Findings 60a Table 4.1 Benefits of Life Review (Birren & Deutchman, 1991) 60a Table 4.2 New Outcomes/Benefits 60b Evidence of Outcomes 61 Sense of increased personal power and importance 61 Recognition of past adaptive strategies and application to current needs and problems 61 Reconciliation with the past and resolution of past resentments and negative feelings 62 Resurgence of interests in past activities and hobbies 64 Development of friendships with other group members 64 Greater sense of meaning in life 65 Ability to face the nearing end of life with a feeling that one has contributed to the world 65 Normalization of one's reactions to trauma or to events (e.g. re-entry) . . . 66 The receipt of specific advice, ideas or assistance 67 Engendering of hope 68 Relief or emotional release in telling one's story 69 Feeling heard/being listened to 71 Relating/Commonality with others 72 New awareness or heightened awareness of one's contributions and/or abilities 76 New awareness or heightened awareness of others' contributions and/or abilities 77 Positive feelings obtained from others' responses to one's story 78 A new appreciation of one's life through comparison with other group members' lives 79 Exploring the Questions 80 Comments on Writing, Reading and Feedback Process 82 Recommendations from Group Members 84 Chapter Five - Discussion 87 Comparison with the Literature 88 Examination of the Outcomes 93 Implications and Recommendations for Future Research 98 Implications and Recommendations for Counselling 101 Impact of Life Review Group on the Researcher 104 VI References 106 Appendices Appendix A - Information Sheet for the Project 115 Appendix B - Consent Form 117 Appendix C - Letter of Consent from Veterans Affairs Canada 119 Appendix D - Interview Schedule 120 Appendix E - Summary of Findings 123 Appendix F - Theme Assignments 124 V l l A C K N O W L E D G M E N T S I wish to express my gratitude to my committee members, Dr. Marvin Westwood, Dr. Norman Amundson and Dr. David Pedlar. Your advice, wisdom, insight and support was greatly appreciated. I am especially grateful to Dr. Westwood, Thesis Chair, for his encouragement, support and guidance throughout this journey. I wish to thank the 10 participants in this study for their honesty and bravery in telling their stories. I wish to also thank all the veterans and peacekeepers who have touched my life both professionally and personally. You were my inspiration for this research. I thank all my friends, family and colleagues who kept me going when it got tough. This is especially true of my parents, Eldrick and Jacqueline Peterson. Finally, and most important, I wish to acknowledge my husband Norm and son Braeden. Your unconditional love makes my story happy each and every day. -1-CHAPTER ONE - INTRODUCTION I. Background to the problem Living in Canada, it is easy to forget that this century has been the most violent period in human history. More than 1.4 million young Canadians have volunteered to serve in our military and merchant navy and more than 116,000 have given their lives (Royal Canadian Legion, 1999). As will be documented in Chapter Two, returning World War II and Korean veterans report both negative and positive accounts of their war experience, reflecting the capacity to experience pain and growth from the same event. On the other hand, McLellan (1997) reports in the "Care of Injured Personnel and their Families Review" that the general dissatisfaction level among recently (1992-1997) injured military personnel and their families ranged between 48.6 percent to 90.9 percent. This dissatisfaction level pertains to seven areas — organizational support, medical support, pension issues, career issues, financial issues, family-related issues and logistical support issues. McLellan goes on to write: personal interviews conducted with 146 respondents were more revealing than statistical facts in that they provided the personal touch, the opportunity for the review team member to 'see' the member or family and, consequently, get a sense of how they were affected by the stories they were telling and what their feelings were" (McLellan, 1997). McLellan's report reflects primarily on the injured personnel's and their families' feelings toward the Department of National Defence and, to a lesser degree, Veterans Affairs Canada (VAC), but in my own work as a counsellor for VAC since 1987,1 believe it is -2-fair to say that these feelings of dissatisfaction are reflective of the personnel's and their families' feelings towards society in general. Hansen, Owen and Madden (1992) in their moving and powerful book Parallels: The Soldier's Knowledge and the Oral History of Contemporary Warfare posit that the wartime service of civilian soldiers must be seen as a covenant. When society sent them to fight its wars, it undertook a reciprocal commitment to reintegrate them and their knowledge back into society when the wars were over. From the perspective of many veterans and peacekeepers, society has failed to honour its good faith commitment to integrate them back into civilian life. Societies have a mixed record of honouring their part of the covenant, often confusing the warrior with the war, or the messenger with the message, or becoming distracted by self-congratulation or guilt, or rejecting the message outright (p. 157). Presently there is a dearth of research on the re-entry experience of World War II and Korean veterans. At the same time Canada is sending more and more of its young men and young women into hostile areas to act as peacekeepers. In this role they are asked to provide a constabulary presence, to monitor the activities of belligerent parties, maintain the safety of noncombatants, ensure the orderly delivery of humanitarian aid, and assist in the building of infrastructures (Litz, King, King, Orsillo & Friedman, 1997). After their tours they too, like the war veterans before them, re-enter civilian life. This strongly suggests a need for further research into the area of re-entry and reintegration of -3-soldiers. It would also be beneficial to have programs that pass on the ways and means of successful re-entry from the older wartime veterans to the younger peacekeeping veterans. The literature is silent on any such programs as described above. This is a shame in light of the fact that Canada has approximately 4000 to 4500 soldiers leaving the forces each year (Leduc, 2000). These men and women will obviously go through a re-entry experience which can impact them significantly. It is estimated that 1.4 million Canadians have experienced this before them, therefore would it not make sense to have some means of passing on what their experience was like, both good and bad, to the younger men and women who are about to re-enter? One way that individuals can begin to make the re-entry process more successful is to participate in a review of life experiences program. Lewis and Butler (1974) developed an individual and group model of life review therapy primarily geared to older adults in which various methods such as autobiographies, pilgrimages, reunions, genealogy and memorabilia were used to stimulate memories. As Chapter Two will demonstrate, most of the work and research into life review has focused on older adults with little to none being done on middle-aged or younger populations. However, Lewis and Butler (1974) did experiment with age-integrated groups including persons over 60, young adults and teenagers, and found that "in a well-functioning group, the generations unite against the vicissitudes of the life cycle...." (p. 173). Benefits they attributed to the life review are: the opportunity to make sense of one's life, the opportunity for re--4 examining and restructuring identity, the opportunity to accept responsibility for actions and to put guilt into perspective, self-understanding with acceptance of both strengths and weaknesses, the opportunity to confront fears of death and the stimulation of creativity. Chapter Two will go on to speak about other work that has been done with younger populations. It will also address some of the intergenerational life review work that is only now beginning to be done. Ashby (1997), in an unpublished study, interviewed six participants of a brief intensive version of the guided autobiography/life review. The participants were representative of each decade between the mid-twenties and the mid-sixties. They reported appreciating the mixed gender group and the range in ages. Comments indicated that this gave depth and breadth to the interaction that would have been lacking otherwise. In an extensive review of the literature though, this researcher could not find any research that has been conducted on intergenerational life review with older and younger soldiers. In fact, the only practice of, and research into life review and veterans that could be found was work that had been done by Molinari and Williams (1995) with World War II POWs with Posttraumatic Stress Disorder (PTSD). Their conclusion was that participation in this PTSD therapy group appeared to be uniformly beneficial for this small sample of World War II POWs, since it was geared to their unique wartime experience. II. Purpose of the study Birren and Birren (1996) stress the need for research focused on how guided -_>-autobiography changes participants. This was one of-the purposes of the -following study although the focus was altered somewhat from a strict life review format. The following questions were explored in this study: 1) What are the specific competencies, skills and knowledge needed for successful re-entry into civilian life? 2) Can these skills, competencies and knowledge be successfully passed on in an intergenerational life review program (LRP) involving both World War II veterans and peacekeepers? 3) Will the intergenerational passing on and receiving of these competencies, skills and knowledge lead to increased feelings of efficacy on the part of both World War II veterans and peacekeepers? 4) What changed for the individual during the course of the program and do they view their lives differently after the guided autobiography/life review experience? The goals of the program were twofold. There were 1.) the research goals coupled with 2.) the goals of, and intended benefits to, the participants. These goals and benefits often overlapped. The research goals were to answer the questions above. The goals, or intended benefits to, the participants were the benefits attributed to life review by Lewis and Butler (1974) as well as any other newly identified benefits that the participants may have experienced. One research goal was the opportunity to identify and analyze the -6-intergenerational benefits of the LRP. These benefits were hypothesized to be the recognition and identification of specific skills by the World War II veterans and the opportunity for this group to pass these skills onto the peacekeepers. For the returning peacekeepers the benefit of this program was hypothesized to be an integrating of these skills into their experience of re-entry into civilian life. These are benefits that could only be attained in an intergenerational group of both older veterans and younger peacekeepers. Other anticipated benefits that are expected to be observed in any LRP are increased awareness of one's accomplishments and achievements, and the challenges that one has faced. Coupled with this will be a greater knowledge about how one has coped with losses and an acceptance of those losses. A final goal and benefit was an acceptance and understanding of one's life lived. As this topic is complex and is something about which little is known, it lends itself to qualitative research. A qualitative method has been chosen as its emphasis is on "discovery, description, and meaning" (Osborne, 1990). More specifically the research method was an ethnographic case study and the means of analysis was interpretational. Interpretational analysis is the process of examining case study data closely in order to find constructs, themes and patterns that can be used to describe and explain the phenomenon being studied (Gall, Borg, & Gall, 1996). III. Significance of study As already mentioned, there is a dearth of research on guided autobiography and life review with middle-aged or younger populations. There is even less in the way of intergenerational research. This study therefore contributes to development of knowledgi about this group design. There is also little research on the re-entry experience of veterans and peacekeepers. This research was therefore further designed to contribute to and build upon the existing knowledge in this area. More specifically, it is intended that this research wil l help broaden our knowledge of soldiers' re-entry experiences from the perspective of the soldier. -8-CHAPTER TWO — LITERATURE REVIEW A good starting point in looking at theories and concepts is to examine what research has been gathered for these theories and concepts. The following literature review is broken down into two parts: first a review of the re-entry experience of veterans and peacekeepers, and second, a review of the life review and guided autobiography methods. Questions that are relevant here are: "What was re-entry into civilian life like for wartime veterans?"; "What is this experience like for peacekeepers?"; "What are the similarities and differences between these two groups in respect to the experience and challenges of re-entry?"; "Why would a life review program (LRP) be important for veterans at this stage in their lives?"; "What impact will the different generations have on each other and the group as a whole?"; and finally, "How will a LRP address the recognition and identification of specific skills by war veterans and the transfer of these skills to peacekeepers?" Parallels between soldiers Before looking at the similarities and differences that exist between the re-entry experience of wartime soldiers and peacetime soldiers it is important to look at the parallels that exist between soldiers period. These parallels, in part, explain why re-entry is a challenge to and is often very similar for both groups. In a thought-provoking book written by Hansen, Owen and Madden (1992) titled Parallels: The Soldiers' Knowledge and the Oral History of Contemporary Warfare they examine the "international -9-brotherhood of warriors." Their findings are based on the experience of American, Soviet, Vietnamese, and Afghan veterans. What they found was that regardless of the theatre of war or their nation's political objectives these veterans' experiences were eerily parallel. They were struck by the extent to which parallels span ethnic, gender, and national boundaries (p. 3). It could be argued however, that the role of a peacekeeper soldier is different from that of a combat soldier. This is true but when one looks at what Hansen et al (1992) identify as the parallels of soldiers it is hard to argue that these were, and are, not also the experiences of peacekeepers. They identify the parallels as: 1. The horror, abjection, and experience of contemporary warfare. 2. The most significant social institution in their experience, the Brotherhood, and, 3. The aftermath, which is in many ways more traumatic, and is certainly more prolonged than the period actually spent in combat (p. 10). Kristeva (1984) defines abjection as the abiding sense of meaninglessness and loss of self that results from prolonged, traumatizing exposure to the horror of contemporary warfare. Herr (1978) identifies it with the responsibility associated with what you see that stays stored in your eyes. Referring to the soldiers, Hansen et al (1992) state that "in order to understand the origins of this psychology accurately, we must remember their extreme youth, their belief in their government and their culture's war myths and the triviality of their basic training". To use a well-understood American figure of speech, they find they have gone "too far" — they have ventured outside the security of their -10-homes and culture and out into a world that does not conform to their expectations. Hansen et al (1992) see the next step into horror and abjection as what they call "blooding." This is when a soldier suddenly and violently participates in killing for the first time (p.65). This is often where a difference can be drawn between a combat soldier and a peacekeeping soldier. The role of a combat soldier involves the killing of others; the role of a peacekeeping soldier rarely does. This is not a small difference and one should never imply that it is, but in looking for parallels it is hard to argue that peacekeeping soldiers do not also experience the horror that has been such a large part of the wartime or combat soldier's experience. Horror is the blank, terrifying, fatal quality in events gone completely out of control — in the damage of war, natural disasters, rape, the Holocaust and so forth (Madden, 1988). Horror and abjection lead quite naturally into what Hansen et al (1992) identify as the second parallel that exists between all soldiers — that being the Brotherhood. Brotherhoods serve many purposes, but first and foremost they were a necessary response to a world out of control, in which their own survival was their paramount consideration. The Brotherhood was the only organization whose sole objective was the member's survival. Though these communities were spontaneously organized and informal, they developed into highly effective defenses against the pervasive horror and abjection (pp. 129-130). The strength of the Brotherhood was the certain knowledge that individual survival was greatly enhanced by collective survival (p. 130). Although Hansen et al -11-(1992) never talk in terms of physical and psychological survival it would be reasonable to assume that collective survival refers to both. The question posed in Parallels: The Soldier's Knowledge and the Oral History of Contemporary Warfare is not whether a combat veteran continues to experience war as aftermath, but rather the degree (p. 156). The book refers only to combat veterans, but if one examines what it is that makes up aftermath we see how it easily fits with anyone — combat soldier, peacekeeping soldier, or civilian — that has witnessed the horror of a combat zone. Aftermath is made up of accounts of estrangement, isolation, marginalization, exaggerated startle responses, searching for "the edge," drifting, unemployment, alienation, survival guilt, flashbacks, anger, broken families, substance abuse, nightmares, suicide attempts and prolonged introspection over having "gone over to the dark side" (p. 156). Again, aftermath spans ethnic, gender and national boundaries. Boris Volkov (1992), a Soviet Posttraumatic Stress Disorder (PTSD) therapist, commented, after a visit to a Veterans Administration Hospital in the United States, that he was "struck by the exact identity — the exact parallel — between the experiences of Soviet and American veterans." Against these sobering facts, the notion that citizen soldier's — particularly those with prolonged combat exposure — will return easily to civilian life can no longer be part of our social definition of war (Hansen et al,1992). After examining a soldier's experience of aftermath, Hansen et al (1992) include a chapter on "Healing" in their book. Healing though, is not identified as one of the - 1 2 -parallels that exist between soldiers. The authors never tell us why they do not include it as a parallel but one may assume that it is because, unfortunately, healing is not part of every soldier's experience. T h e r e - e n t r y p r o c e s s Many of the parallels identified by Hansen et al (1992) are experienced by soldiers in the actual theatre of war. Others such as aftermath are experienced after the war has ended. This brings us to re-entry. As significant to many soldiers as their wartime or peacekeeping experience is their re-entry experience, yet there is a dearth of information on this particular topic. Significant information about re-entry though, whether wartime or peacetime, can be extracted from much of the other research done on soldiers. One thing that we do know is that when it comes to PTSD symptomology, less severe symptomology is reported among World War II veterans compared with Korean and Vietnam veterans (Fontana & Rosenbeck, 1993). This could conceivably be due to the greater popularity of World War II, the greater stigma attached to mental illness by American society during the formative years of the World War II generation, or both (Fontana & Rosenbeck, 1993). What may be suggested though, is that being treated more as heroes at the time of homecoming may have mitigated the impact of war experiences on psychiatric symptoms of World War II veterans. World War II had popular support, the Korean war started out that way but support waned as the war went on, and the Vietnam war was not at all supported at home. -13-Many recent Canadian peacekeepers also report feelings of disillusionment, despair, and abandonment (McLellan, 1997). They feel that they have been unfairly branded as "racists" and "rapists" because of the actions of just a few of them. They also feel that their sacrifices and contributions have been lost in the controversy surrounding the Canadian Armed Forces. The long-term effects of this lack of recognition and understanding of what they have been through on the psychological being is yet to be known. What we do know from the vast research done on Vietnam veterans is that on the whole the differences that Vietnam veterans were found to have in their interpersonal relationships were attributed less to their exposure to the stress of combat than to their alienation from a country that had become disillusioned with the war and no longer accepted them as full members of their communities (Solomon, 1993). Another valuable lesson that we learn from the research done on Vietnam veterans is the importance of making treatment available to soldiers upon their return from combat zones. In a study done by Stretch (1991) on the psychosocial readjustment of Canadian Vietnam veterans, he found that Canadian Vietnam veterans exhibited greater rates of PTSD compared with United States Vietnam veterans. Evidence of other psychosocial adjustment problems such as depression, inability to handle frustration and anger, difficulty in getting along with and trusting others, and family and mental problems, as well as poor physical health, was also found. Results suggest these problems are due, in part, to prolonged isolation from other Vietnam veterans, lack of recognition and no -14-readily available treatment for PTSD in Canada (p. 188). And although PTSD stands out as being particularly troublesome for soldiers and the societies that they return to, there are other residuals on soldier's functioning that impact the nature of their re-entry. Solomon (1993) noted in her research on Israeli soldiers who had fought in a number of different theatres of war that even soldiers without PTSD thought and dreamt about the war and were somewhat closed, irritable and depressed at homecoming; their minds were still on the battle and their hearts with the people they had lost. In addition to coming face-to-face with the evil and ugliness of the world, sociologists have shown that military service has effects on the timing and sequencing of adult roles and on educational and occupational attainment for returning soldiers (Anderson & Mitchell, 1992). Soldiers who go to war generally leave behind a vacuum — in their families, communities, and work — that is filled by the people who stay at home. When they return, they often find that their wives have taken upon themselves both parental roles, that their children have assumed more responsibilities and colleagues at work have intruded on their territory (Solomon, 1993). Not surprisingly, late mobilization for military service defined by age, generally increased complaints about family stresses and career setbacks (Elder, 1987) regardless of combat experience. For some veterans though, reestablishment credits, and particularly the opportunity to further their education, worked to advance their careers and gave them opportunities that they may not otherwise have had. -15-In respect to other positive aspects of the war, several veterans had indicated that the war not only gave them excellent transfer of the skills related to job success, but boosted their self-esteem in that the war experience helped them mature quickly (Westwood, 1998). In the Berkeley study (a study with a sample size of 149 veterans that was longitudinal in nature) the timing of turning points in men's lives were found to have been altered by military service. Sometimes this had positive outcomes; sometimes negative. By entering military service in the 1940's and 1950's, Berkeley men altered their life course in several ways such as by accelerating or delaying the timing of other life events like marriage and childbearing (Elder Jr., 1986). Compared with non-veterans, American veterans of World War II and Korea show substantial delay in school completion, full-time employment, and marriage timing (Hogan, 1981). A second way that some Berkeley men altered their life course was by rearranging the usual order of life events, such as marrying before finishing school (Elder, 1985). Hogan (1981) observed such rearrangements among veterans in his national sample, a pattern less common among non-veterans. As to whether or not this same pattern would hold true for peacekeeping veterans the literature is silent on this topic. What we do know though, is that many peacekeepers are career soldiers unlike the World War II veterans who temporarily left their jobs and occupations to fight in a war. One would therefore expect that their experience around the timing of life events and job displacement would be different than that of the wartime veterans. On the other hand, if the peacekeepers are -16-reservists or retire from the military upon returning from peacekeeping missions there is no reason to believe that their experience would be any different than that of the wartime veterans. Impact of re-entry on families Thus far in this literature review, we have focused mainly on how one's military experience and re-entry experience effect them personally. Of course, as with all of life's experiences, the impact of one's military experience is felt by more than just oneself. Very often the arena in which combat exposure has the greatest impact is that of the family. Yet again there is a dearth of research on this particular topic. In an interesting book edited by Segal and Segal (1993) titled Peacekeepers and Their Wives, the effect of the life disruption caused by military operations is explored. This particular book looks at the experience of American paratroopers and lightfighters during the Sinai operation in 1982. It not only looks at how this operation impacted the soldiers but also on how it impacted their wives, and to a lesser degree their children. Bartone, Harris, Segal and Segal (1993) did research on the health problems of deployment. Their research was embedded on the first paratroopers to serve in the Sinai and focused not only on the health of the soldiers but also on that of their families. The reasoning behind this was that if the families experienced health problems due to the stress of deployment, this would be an additional source of stress for the deployed soldier. There had been some anticipation that the stress of deployment would be reflected in increased illness among the families, -17-but the change that these wives saw in themselves was, for the most part, not traumatic. In fact, there was no significant illnesses during the deployment. However, there was an increase in reports of those symptoms most commonly related to stress. Headaches, weight changes, sleep disturbances, and menstrual irregularities were reported by several participants in the study, and increases in these symptoms were confirmed by the post's medical personnel (Van Vrankenetal, 1984). The sources of stress reported by the wives included parent-child relationships, sole responsibility for decision-making, loneliness, responsibility for the maintenance of automobiles and appliances, handling of finances and concerns about marital trust and fidelity (Bartone et al 1993). While doing research on the health problems of deployment Bartone et al (1993) discovered one area of conflict, or potential conflict, that they had not anticipated when they started their research on the paratroopers and their wives. This area was the increased freedom that wives expected after their husbands' return from the Sinai. Apparently, they had constructed an element of their relationship that their husbands did not share. Subsequent to the return, wives reported significantly less freedom to do the things they wanted to than they had expected. There was a marked increase in illness among the wives. Additionally, almost half the children suffered an illness after their father's return, which was possibly related to the stresses of re-adjustments and the attempts to reintegrate the fathers into the lives of the families (Bartone et al 1993). This finding was not unique to the paratroopers and their families. In Gravino, Segal and -18-Segal's (1993) research on lightfighters and their wives they discovered this same conflict, or potential source of conflict. They write; as the novelty of reunion wore off, differences in expectations became more apparent. As had been the case in the paratroopers' families, the deployment had been a time of growing confidence for the women, while the soldiers in the Sinai had found time standing still for them and had expected that things would remain the same at home as well. Most of the women who were proud of their success in dealing with the separation were hurt to one degree or another by their husband's seeming indifference to their accomplishments. On the other hand, men who were eager to resume participatory roles in the family were confused and resentful of their families' ability to get along without them (p. 149). In regards to the veterans' experiences, I could not find any research to suggest that the experiences of World War II veterans and their wives were the same. It is important to remember though, that World War II veterans returned home at a very different time in history. Women had taken on many of the work and family responsibilities vacated by men when they had gone to war but if they felt any resentment at their loss of roles after the men's return they would have been unlikely to have voiced them. Another difficulty identified by Gravino et al (1993) research on lightfighters and their wives was the nervousness and uncomfortableness of reunion. When asked about the upcoming reunion experience, one lieutenant's wife said, "It's scary. The man I'm married to, who's become a stranger, is coming home tomorrow." There was an awareness that previous constructions of the marital relationship might no longer hold. This feeling of apprehension was also felt by veterans and their wives 40 to 50 years ago. In the Life Review Program for Canadian Veterans (LRPCV) run in Vancouver in 1998, -19-one participant who had not really had a chance to get to know his wife before he went overseas for five years, said of renewing his relationship with her; "I approached it just like a lover ... we were strangers to each other" (Westwood, 1998). Ford et al (1993), in their research into psychosocial debriefing after Operation Desert Storm (ODS), break the stressors down into three stages: premobilization stressors, activation and mobilization stressors, and finally, readjustment stressors. These stressors have a cumulative effect. The ODS experience began for veterans and their families in the first few months of anticipatory anxiety and bereavement beginning at the outset of the Iraqi invasion of Kuwait in August 1990. There was the following: mixed apprehension and eagerness on the part of the military personnel; family conflict triggered by the impending possibility of major financial, vocational, parental, and spousal role changes and strains; disruption of normal family life cycle events (e.g. children returning to school in September, birthdays, pregnancies, and new births), and holidays (e.g. Thanksgiving, Christmas, Hanukkah); and a series of repeated "false starts" when call-up seemed imminent but was called off or postponed at the last minute. These stressors were baseline for the next few months cumulative stress (Monroe & Simons, 1991). The activation stressors included making critical personal and family decisions on very short notice. Some decisions were rather morbid (e.g. updating wills and insurance policies), others were frustrating (e.g. relinquishing job positions with no guarantee of return and no compensatory source of income), and others unwieldy (e.g. placing children and -20-spouses in the care of other family members or friends, or bringing family or friends into the home to help out) (Ford et al., 1993). For most of the veterans, the next step in ODS service was an unannounced and abrupt departure. During the actual mobilization period spouses and families reported manifesting a classic symptomatic pattern (Horowitz, 1986) of alternating intrusion (e.g. tense preoccupation with monitoring the war on CNN, feeling hypervigilent and hyperaroused as a result of covertly imagined scenarios of death and loss), and avoidance/numbing (e.g. managing work and family life like automation) during the ODS mobilization (Ford et al., 1993).The readjustment stressors that Ford et al (1993) write about are really no different than the re-entry stressors identified by Bartone etal(1993). They write; many soldiers filled demanding roles during mobilization, only to find themselves either demoted to a lesser level of responsibility and status in civilian jobs or family roles, or they returned to find that their former situations were no longer fulfilling or challenging. Again, there is little to no research on the premobilization stressors, activation and mobilization stressors and readjustment stressors of World War II and Korean veterans. There is though, no reason to expect that the experience of veterans and their families 40 to 50 years ago would be that different to those of recent veterans and peacekeepers. They may not have had CNN but they did have newspapers and radio, and it is hard to imagine that tense preoccupation did not make up part of their loved one's experiences. Thus far what has been presented in this literature review is many of the challenges that have faced veterans and peacekeepers. They have not been presented to -21-paint a negative picture of a soldier's re-entry experience, but instead to draw light to the fact that re-entry is never easy, is never without challenge, and because of this has a significant impact on a soldier's life. Most veterans though, have done well in their lives and it is important to not only mention this but to honour it. Many veterans report positive aspects to their combat experience. Apparently, combat experience inoculated some men against future stress. In comparison to that trauma, daily stressors were insignificant. Other men spoke of their battlefield promotions and their pride in discovering that they could successfully command and protect other men. They felt that if they could cope with war, they could cope with anything (Aldwin, Levenson & Spiro III, 1994). And it goes beyond just personal accounts, clinical ratings show that heavy combat veterans become more resilient and less helpless over time when compared to other men (Clipp & Elder Jr., 1989). There were also potential benefits to war mobilization for the society and the individual. Consider, for example, the early mobilization of men for service in World War II, a timing which increased their educational prospects through the G.I. Bill (Elder, 1987). Canada also provided educational benefits to World War II and Korean veterans through the Pensioners' Training Regulations. There is no reason to believe wartime experience would be different from any other experience in that there would be positive and negative aspects to it. The Berkeley men in their 1985 follow-up were asked to provide subjective accounts of their war experiences. Recollections were negative and positive, reflecting -22-the capacity to experience pain and growth from the same event (Clipp & Elder Jr., 1989). World War II veterans and life review Another question that I earlier stated that was germane here was, "why would a LRP be important for veterans of this stage in their lives?" What was discovered from the 1998 pilot project on the Life Review Program for Canadian Veterans (LRPCV) was that the benefits to the participants were many and varied. These included: • providing a forum for validation of their major life experiences in an • atmosphere of comradeship and support. • enabling them to integrate the war experience into their lives lived; both the losses and gains. • allowing for reconciliation of past life events with the present. • identifying achievements and effective coping strategies. • facilitating healing for those who have experienced PTSD. • consolidating and developing future focus for life goals. • identifying a desire for World War II veterans to assist in the re-entry of peacekeepers. • bringing peace of mind that their contributions to their country were important and will not be forgotten (Westwood 1998). -23-In regards to the benefit of facilitating healing and personal integration for those who have experienced PTSD, a new phenomena has been observed and coined delayed PTSD. This is used to describe veterans with an apparent first onset of symptoms in later life (Clipp & Elder, 1996). A number of examples of delayed response appear in case reports. Clinical reports suggest that age-associated losses such as retirement, death of loved ones, children leaving home, or a decline in health can reactivate symptoms of PTSD. Collectively, these declines or losses resemble a prime feature of wartime trauma — a lack of control. It seems that situations in later life that symbolically represent wartime trauma can elicit symptoms that were latent for many years (Clipp & Elder, 1996). Lipton and Schaffer (1986) postulated that age weakens previously adequate defenses. Van der Kolk and Ducey (1984) noted that some retirement-age veterans, after years of symptom-free living, experienced nightmares about traumatic events in World War TI when faced with a loss of structure provided by their jobs. The reasons for the delayed onset of symptoms are unclear, but it has been suggested that some veterans experience a successful but premature closure of trauma which remains dormant until a powerful reminder (Van Dyke et al., 1985) or a breakdown of conscious or unconscious defenses ushers in symptoms. A LRP could provide veterans with a structured environment in which to discuss their losses and accomplishments. By bringing in the younger peacekeepers to teach and mentor, the veterans would be provided with an opportunity to contribute. It brings in an element of generativity. It should be noted -24-though, that a LRP is not only for individuals who have been diagnosed with PTSD. As a matter of fact, the requirements of being able to communicate their life experiences in a coherent way (with respect to time, place, and person), being comfortable in a group setting and being self-reflective and motivated to participate (Westwood, 1998) may preclude many individuals with PTSD. It is important to remember though, that there are other veterans with only one or two symptoms of PTSD who do not meet the criteria for a PTSD diagnosis, yet are still struggling with the legacy of combat (Clipp & Elder, 1996). Despite the recognition of late onset PTSD in aging war veterans and the acceptance and wide use of life review programs with the aging population in general, this researcher could only find one research study that combined the life review method with the aging veteran population. More specifically, Molinari and Williams (1995) looked at a subgroup of veterans — aging World War II POWs with PTSD. A variety of studies have reported wide-ranging estimates of PTSD in older POWs from 29 percent (Speed, Engdahl, Schwartz & Eberly, 1989) and 46 percent (Zeiss & Dickman, 1989) to 90 percent (Sutker, Winstead, Galina & Allain, 1990). Such differences probably reflect varied definitions of PTSD, the scales used to measure the concept and the time intervals after the POW experience when assessment was conducted. Molinari and Williams' (1995) group consisted of nine core members, four who occasionally attended, and an additional 13 who came for a period of time during the seven years that the group ran. With rare exception, the group consisted of former POWs who functioned independently -25-in society after their release from captivity. They had relatively stable work, marital and family histories, although many recognized and were able to describe the negative effects of PTSD on their lives. Six of the nine core members reported symptoms which met the D S M - HI - R criteria for diagnosis of PTSD. Another had mild symptoms of PTSD but did not meet full PTSD criteria, and two other group members did not report significant symptoms of PTSD. Al l the group members with PTSD felt that their symptoms had become worse with age (possibly motivating them to seek treatment as older adults), particularly upon retirement, suggesting that productive work activity had helped them to deal with their trauma by creating a structure and giving meaning to their lives (Molinari & Williams, 1995). This research reinforces the research of Van der Kolk and Ducey, (1984) and Van Dyke et al. (1985). Molinari and Williams' (1995) conclusion was that participation in this PTSD therapy group had appeared to be uniformly beneficial for this small sample of World War II POWs, since it was geared to their unique wartime experiences. They further write, "the life review concept may help explain the positive effects of group therapy involvement despite the great length of time since the actual trauma. Butler (1963) proposed that with aging there is a realization of approaching death, which initiates a return to consciousness of long-repressed past experiences. A late-life developmental task is the reintegration of these old memories into a positive but realistic self-conception, so that intrapsychic cohesion can be achieved and wisdom pursued. One needs to be able to -26-accept life as it has been lived before the future can be embraced or else withdraw into depressive guilt and despair." Molinari and Williams then go on to describe how the process of these groups are similar to traditional life review groups except that much of the discussion is centered around a common central organizing event which impacted all other aspects of these veterans lives — that being their POW experiences. Interesting from this researcher's perspective, is the identification by Molinari and Williams that this particular life review program may have benefits further reaching than just to the veteran participants themselves. They write, "by revealing their 'survival strategies against the odds', POWs can also leave a legacy by chronicling the strength of the human will for the group leaders to pass on to future generations." This begs the question, "what would the benefits be if this future generation participated in the group with them; particularly if this future generation had been through a somewhat similar experience?" Life review and guided autobiography When Butler (1963) first conceptualized life review he saw it as something beneficial for people to participate in their older years. He proposed that with aging there is a realization of approaching death, which initiates a return to consciousness of long-repressed past experiences. He saw a structured life review process as allowing the older individual to end their life in integrity (as defined by Erickson, 1968) and not in despair. Butler's own work and the work that followed his for a number of years focused on the benefits of life review to varied elderly populations. The life review intervention -27-continues to be used effectively with a number of elderly populations — older workers coping with job loss and depression (Rife, 1998), elderly female survivors of childhood sexual abuse (Mclnnis & Dittrich, 1996), depressed homebound older adults (McDougall, Blixen & Suen, 1997), older adults newly admitted to nursing homes (Tabourne, 1995), and so forth. What is starting to emerge though, is life review interventions being used with middle-aged and younger populations. Lewis and Butler (1974) experimented with age integrated groups including persons over 60, young adults and teenagers, and found that "In a well-functioning group, the generations unite against the vicissitudes of the life cycle" (p. 173). Research into Life Review in Family Psychotherapy (Sukosky, 1994), using Guided Autobiography with Dying Children (Seaton, 1992), looking at the Psychological Effects of a Life Review Intervention for Persons with HIV Disease (Vaughan & Kinnier, 1996), and so forth, demonstrates the growing acceptance of life review interventions being used with middle-aged and younger populations. What has yet to be widely explored is the effectiveness of life review with intergenerational groups. There is clinical work and research though, that has started to be done in this area. Sukosky (1994) and Hargrave and Anderson (1992) have done family psychotherapy with intergenerational families. In an unpublished study, Ashby (1997) interviewed participants of a brief intensive version of the guided autobiography/life review. The six participants range in age from 26 to 63. Participants reported appreciating the mixed gender group, and the range in ages. Comments indicated that this gave a depth and -28-breadth to the interaction that would have been lacking otherwise. The guided autobiography process is a two-part process incorporating both self-reflection and interaction. The self-reflection pre-group aspect of the program involves the theme-focused writing of the autobiography using the sensitizing questions as a guide and stimulus. The interactive group process involves reading of the story and hearing non-evaluative feedback from group members, as well as hearing and responding to the stories of others (Birren & Deutchman, 1991). It is a technique that works extremely well in doing life review groups. As for the final question, "How will a LRP address the recognition and identification of specific re-entry skills by war veterans and the transfer of these skills to peacekeeping veterans?" much of the answer lies in the outcome of this program for Canadian war veterans and peacekeepers. This program is based on a lifespan perspective of development and will utilize a combination of guided autobiography and interviewing of older veterans by the younger peacekeepers. This will all be done within a small group setting. There are a number of reasons that the guided autobiography method should be effective in facilitating the goal of recognition of re-entry skills and the transferring of these skills, plus facilitating many other benefits for the participants. This group method gives participants the opportunity to integrate life experiences (Birren & Hedlund, 1987), maintain a sense of continuity of the self over the passage of time, resolve past conflicts, and review and affirm values and goals (Birren & Deutchman, -29 1987). In reviewing their lives participants are reminded of contributions they have made which may have been forgotten. A heightened awareness of the significance of one's life can therefore result (Birren & Deutchman, 1994). There is also no reason to believe that once participants are reminded of their contributions that they cannot pass on the knowledge, skills and competencies that allowed them to make these contributions. -30-CHAPTER 3 — METHODOLOGY Research design In reviewing the studies on veterans and peacekeepers that were examined in Chapter Two, one notes an almost even split between quantitative and qualitative research with some studies using a combination of both. From a personal perspective this researcher found the qualitative studies to be richer, more descriptive and more meaningful. The majority of studies on life review have been quantitative in design, paralleling the methodology predominately used in gerontological research (Berma, 1995). This seems rather ironic in light of the fact that life review is about "telling one's story" — a process that would seem to naturally lend itself to qualitative research. A qualitative research design was therefore chosen for this study as qualitative research seeks to understand the meaning people give to their experiences; information or meaning that is expressed in words not numbers (Schumacher & McMillan, 1993). Furthermore, as relatively little research has been published in the area of intergenerational life review and guided autobiography, and in the area of soldiers' re-entry, a qualitative method has been chosen as its emphasis is on "discovery, description, and meaning" (Osborne, 1990, p. 168). Ethnographic case study Tesch (1990) identifies ethnography as the most common type of qualitative method used in educational and psychological research. The focus of ethnography is to -31-understand the culture from an emic (insider) and etic (outsider) perspective. Culture can be defined as the behaviour, ideas, beliefs, and knowledge of a particular group of people (Mertens, 1998). Ethnography, often referred to as naturalistic inquiry, includes those methods of observation and data collection that do not interfere with the "natural flow of events or action" (Schumacher & McMillan, 1993, p. 594). These methods often include observation and interviewing of participants in natural settings. Some authors view the case study as one type of ethnographic (interpretive) research that involves intensive and detailed study of one individual or of a group as an entity through observation, self-reports, and other means (Langenbach, Vaughn & Aagaan , 1994; Tesch, 1990). The life review group for veterans and peacekeepers examined in this study constituted such a case study and the means of analysis was interpretational. Tesch (1990) reviewed various approaches that have been used to analyze case study data. She classified them into three types: interpretational analysis, structural analysis, and reflective analysis. Interpretational analysis is the process of examining case study data closely in order to find constructs, themes, and patterns that can be used to describe and explain the phenomenon being studied (Gall, Borg & Gall, 1996). Data collection The researcher is the instrument in qualitative research studies. In other words, instead of using a test or questionnaire to collect data, the researcher is the instrument that collects data by observing, interviewing, examining records and documents in the -32-research setting, or using some combination of these methods (Mertens, 1998, p. 317). Multiple methods are used to collect data about a phenomenon. This enhances the validity of the case and is referred to as triangulation (Gall, Borg & Gall, 1996). Triangulation was used to collect data in this particular study exemplified by the following methods of data collection: Ethnographic interviews Although observation allows collection of data through the researcher's direct contact in the setting, it is not always possible to have intimate, repeated, and prolonged involvement in the life and community of the respondents (McCracken, 1988). This is where interviewing can play an invaluable role. Interviewing can be structured or unstructured, group or individual. In this particular study the interviews were individual and could be classified as structured and unstructured. Mertens (1998) writes, Typically, interviews in a qualitative study are done with an unstructured or minimally structured format. Interviewing can be conducted as part of participant observation or even as a casual conversation. The questions emerge as the researcher is sensitized to the meanings that the participants bring to the situation. As the study evolves, interviewing can become more structured and formal (p. 321). This is a process that accurately describes what took place in this research study. Over the six weeks that the group ran, there were "conversations" that took place between the researcher and the participants. These "conversations" took place before the start of group, after group and during the week between group meetings. At the end of the life review group a more structured and formal interview took place with all the participants. --33-The first question asked was, "To begin, I would like to hear about your experience in the intergenerational life review group." This question elicited a vast array of answers from the different participants. It resulted in information-rich data. It should be noted that when it came to actual data analysis the structured interview data was given more credence than the unstructured interview data. This was because it was audio-taped and therefore could be revisited by the researcher over and over again, it was verified by all participants and all group members had taken part in a structured interview, whereas not all had taken part in unstructured interviews. The unstructured interview data became part of this researcher's field notes. Interviewing proved more difficult than this researcher could have ever imagined. For approximately 14 years I have worked in a social work or counselling capacity, assessing and interviewing people on a regular basis. I feel that I have good skills in advanced empathy, paraphrasing, summarizing, remaining fully present, attending, probing and so forth and yet I struggled with this aspect of the research. In retrospect, I feel I was overly concerned with the interviews being standardized. Although I went in with a combination of standardized open-ended questions and an interview guide approach, an interview is an interaction between two people and therefore can go off in many different directions. In the first few interviews I tried very hard to stick strictly to the interview guide so that I would not be asking some participants questions that I had not asked others. Because of this I feel that there were certain missed opportunities in the -34-early interviews — opportunities to engage in further probing or further questioning that came out of the participants responses to the questions contained in the interview guide. Interviews with each participant were conducted at a mutually agreed upon location. Nine of the 10 interviews took place at the participants' homes and one took place in a private office of Veterans Affairs Canada (VAC). The objective of each interview was to obtain a detailed, comprehensive description of each participant's experience in the intergenerational life review group. Participants were reminded that their participation in the interview was voluntary and that they could withdraw from the interview, or ask to pass on a certain question, at any time. The length of each interview varied. Most were about one hour with the shortest interview being 50 minutes and the longest two hours. Each interview was audio-taped and then transcribed. After transcription and data analysis a validation interview was completed with each participant. At these meetings participants were presented with a summary of their interviews and a summary of findings (See Appendix). The interview summaries were signed off by the participants. Seven of these interviews took place at the participants' homes, two at the Surrey office of V A C , and one package was mailed out to a participant. Observation andfield notes Qualitative observation occurs in naturalistic settings without using predetermined categories of measurement or response (Adler & Adler, 1994). The researcher is interested in observing peoples' behaviours as they naturally occur in terms that appear to be meaningful to the people involved. Adler and Adler (1994) go on to further distinguish between just observation and participant observation. Participant observation is used more frequently in qualitative research and in this type df research, the researcher usually wants to interact with the participants while collecting data from them (Mertens, 1998). Spradley (1980) goes even a step further than Adler and Adler and identifies five types of participation: non-participation, passive participation, moderate participation, active participation, and complete participation. It was active participation that was used in this guided autobiography group with Canadian veterans and peacekeepers. In active participation, the researcher does what the others do, generally, but does not try to blend in completely (Spradley, 1980). My role in this group was that of co-facilitator. It was fully explained to the 10 group members that I had also taken on the role of researcher and observer. It was obvious to the group members that I was writing field notes during the group meetings. Content and process notes were kept throughout the study. Content notes were kept throughout the actual meetings of the group and recorded, often verbatim, what the participants said. Process notes were usually written immediately following the meetings and were often my reactions to what had taken place that night. Process notes also arose out of the debriefings I would have with the group leader immediately following each session. Sometimes they were also reactions that group members would discuss either with myself or the group leader, and at times they were those "huh-huh" moments that -36-came up within the group meeting itself. Documents and records review A l l organizations leave trails compiled of documents and records that trace their history and current status (Mertens, 1998). V A C is no exception to this. It also has a trail of documents that trace the history and current status of their clients. As nine of the 10 group participants were clients of V A C , this information was available to the researcher and access to this information was negotiated right up front with V A C and with the participants. Although in some instances complete holistic assessments were available on participants, this researcher decided against using this material except for one purpose. The only purpose that this information was used for was to find out i f participants had been diagnosed with any psychological problems. This was not to preclude them from the study, but to ensure that safeguards would be put in place to deal with their care and well-being. As for the other information available, this researcher decided not to use it in the spirit of life review. Life review is about allowing individuals to tell their own stories — not having records speak for them. Data analysis Data analysis in qualitative studies is an ongoing process. It does not occur only at the end of the study as is typical in most quantitative studies (Mertens, 1998). Qualitative studies are recursive —•- findings are generated and systematically built as successive pieces of data are gathered (Stainback & Stainback, 1980). Inductive as opposed to -37-deductive data analysis is also a characteristic of qualitative research. The categories and patterns emerge during data analysis; they are not formulated beforehand. This type of analysis involves synthesis, interpretation, selection, categorization and comparison of data collected (Schumacher & McMillan, 1993, p. 480). The researcher must become immersed in the data and examine with a sense of wonder. By using an inductive approach, the researcher can attempt to make sense of a situation without imposing pre-existing expectations on the phenomena under study. Thus, the researcher begins with specific observations and allows the categories of analysis to emerge from the data as the study progresses (Mertens, 1998, p. 160). Without preexisting theory though, one may wonder where to begin. One can begin with grounded theory. Grounded theory was developed by Glaser and Strauss and can be described as "a general methodology for developing theory that is grounded in data systematically gathered and analyzed" (Strauss & Corbin, 1994, p. 273). The defining characteristic of grounded theory is that the theoretical propositions are not stated at the outset of the study. Rather, generalizations (theory) emerge out of the data themselves and not prior to data collection. Thus, the emergent theory is grounded in the current data collection and analysis efforts. Although I came to this study with some ideas (not theories) of how an intergenerational life review group would effect its participants I had to change many of these ideas as the data emerged. Because the initial or emerging theory is always tested against data that is systematically collected, this -38-approach to research has been called the constant comparative method (Mertens, 1998). From the onset of this study — the day I spoke to the first potential participant over the telephone, to the moment I wrote my last sentence for the "Results" Chapter — I was comparing bits of one piece of data with bits of another piece of data. Even when it came to formulating the Summary of Outcomes (See Appendix), traditional content analysis defined as allocating instances to a set of predefined, mutually exclusive and exhaustive categories (Henwood & Pidgeon, 1992) was not used. In the early phases of grounded theory, the researcher is endowed with maximum flexibility in generating new categories from the data (p. 103). With this in mind, this researcher looked for new categories or themes to emerge from the data as opposed to just looking for verification or non-verification of Birren and Deutchman's (1991) outcomes of guided autobiography. Another major aspect o f data analysis in both quantitative and qualitative research is critically analyzing the research. Criteria forjudging the quality of qualitative research that parallels the criteria forjudging positivist, quantitative research has been outlined by a number of writers (Guba & Lincoln, 1989; Stainback & Stainback, 1988). Guba and Lincoln equate credibility with internal validity, transferability with external validity, dependability with reliability, and confirmability with objectivity. They added the additional category of authenticity for qualitative research (Mertens, 1998). These five criteria were met in this study: -39-Credibility In qualitative research, the credibility test asks i f there is a correspondence between the way respondents actually perceive social constructs and the way the researcher portrays their viewpoints (Mertens, 1998). A number of research strategies can be used to enhance credibility. In this study a number of research strategies were used. These included prolonged and substantial engagement, persistent observation, peer debriefing, member checks and triangulation. Although there is no hard and fast rule that says how long a researcher must stay on site, as the researcher, I spent over 25 hours with group members before the interviews. I also engaged in peer debriefing with the group leader who, at times, confirmed my findings, conclusions, analysis and hypothesis but at other times challenged them. Member checks were also conducted in the final validation interview. Transferability In qualitative research, the burden of transferability is on the reader to determine the degree of similarity between the study site and the receiving context. The researcher's responsibility is to provide sufficient detail to enable the reader to make such a judgement. Extensive and careful description of the time, place, context and culture is known as "thick description" (Mertens, 1998, p. 183). I feel that sufficient detail was provided in this study. - 4 0 -Dependability Guba and Lincoln (1989) identified dependability as the qualitative parallel to reliability. Reliability means stability over time in the post positivist paradigm. In the constructivist paradigm, change is expected, but it should be tracked and publicly inspectible (Mertens, 1998, p. 184). Field notes documented each step of the research process in this particular study. A n example of change, or the acceptance of change, by myself in this study was that when I first went into this study I strongly anticipated that there would be a transferring of "concrete" specific advice, ideas or assistance from the war veterans to the peacekeepers. This happened but to a lesser degree than the passing on of the "gifts" of normalization of one's reactions to trauma, the engendering of hope and the feeling of being heard or listened to. I had to make a shift in my thinking as to what would be the greatest benefits of an intergenerational life review program. Confirmability Confirmability means that the data and their interpretations are not figments of the researcher's imagination (Mertens, 1998, p. 184). The influence of the researcher's judgement is minimized. Guba and Lincoln (1989) recommend a confirmability audit to attest to the fact that the data can be traced to original sources and that the process of synthesizing data to reach conclusions can be confirmed. Three of the transcripts were read by Ron Key, a counsellor at Vancouver Community College, who is familiar with life - 41 -review as a validation check. He was asked to look for evidence of the outcomes and note others he found significant. I then compared his results with my own. Authenticity This refers to the presentation of a balanced view of all perspectives, values, and beliefs (Stainback & Stainback, 1989). It answers the question, "Has the researcher been fair in presenting issues?" What amazed me in this particular study was the parallels that exist amongst soldiers in their perspectives, values, and beliefs. I do feel though, that when differences arose that they were fairly presented. Also within the group setting differences were heard, acknowledged and respected. Participants Purposeful sampling The participants were selected for this research through a method known as "purposeful sampling" (Patton, 1990). Purposeful sampling is a means of selecting participants on the basis that they fit the purpose of the study. Further, the type of purposeful sampling that was employed is referred to as "convenience sampling." Convenience sampling means that the persons participating in the study were chosen because they were readily available (Henry, 1990; Patton, 1990). The participants of this particular study were recruited through the Life Review Program for Canadian Veterans that ran in the summer of 1998 (Westwood), Veterans Affairs Canada, the Royal Canadian Legion and various peacekeepers organizations. The requirements for -42-volunteers were being able to communicate their life experiences in a coherent way (with respect to time, place, and person), being comfortable in a group setting, and being self-reflective and motivated to participate (Westwood, unpublished, 1998). Four of the five World War U veterans who volunteered had participated in the life review group for veterans run the summer before. The other was a referral from the Royal Canadian Legion. Three of the peacekeepers who participated in the group were referrals from Veterans Affairs Canada, one was a referral from the Canadian Peacekeeping Veterans Association, and one this researcher had met at a special meeting of the Vietnam Veterans of Canada. Demographics It is important to note that an ethnographic case study is not concerned primarily with generalizability but with access: "It is to gain access to the cultural categories and assumptions according to which one culture construes the world" (McCracken, 1988, p. 17). Taking this into consideration it is important to note that many of the following demographics have little meaning outside the military culture. They are though, very important within that culture itself. The age range for the 10 participants was 30 to 82 years old. Two participants were in their 30's, two in their 40's, one in his 60's, three in their 70's, and two in their 80's. The mean age of the group was 60.5 and the median was 69. The mean and median ages may not demonstrate how intergenerational this particular group was but this researcher feels that the range does. -43-Six of the participants served in the army, one in the navy, and three in the airforce. All three of the Canadian forces were represented. Only one of the participants was an officer; the others were from the enlisted ranks. Nine of the 10 participants were in the regular forces and one was a reservist. Five of the participants had long service, defined as 20 or more years in the forces. All had either served overseas during World War II or had served in a Special Duty Area as peacekeepers. Special Duty Area service represented in this group included the Golan Heights, India, Pakistan, Yugoslavia, Croatia, and Egypt. One group member had served during World War II, the Korean War, and during the India/Pakistan conflict. Three of the five World War II veterans and two of the peacekeepers had not completed high school. One veteran and one peacekeeper have university education. All five of the World War II veterans and one peacekeeper are retired. By and large they had successful careers in various areas — pharmacy, corrections, logging, flying, and so forth. Of the remaining four peacekeepers, two are currently working, one is completing a Social Work degree, and one is struggling with job/career re-entry. He stated in his final interview that now that he is starting to feel better he wants to pursue a career in forestry. Ethical considerations Informed consent was explained to group participants both verbally and in writing. After having an opportunity to ask questions about the group and about informed consent each participant signed a consent form to be part of the research study. Any participants -44-needing support in the time between group meetings were offered this by the researcher and group leader. As a means of assuring confidentiality and privacy pseudonyms were used in reporting the research results. Of concern, to this researcher, was my dual role. In addition to being the researcher of this study I was also at the time, a counsellor with VAC. Participants were assured that a refusal to participate, or a withdrawal from this study would not jeopardize their standing with VAC. This was done both verbally and in writing. The Ethics Review Board was also provided with written confirmation from the Regional Director General of VAC (See Appendix) that VAC supported my thesis proposal and concurred with me using veterans or peacekeepers who volunteered or consented to participate in my research. Limitations of the study First, the participants in this study did not constitute a representative sample of all World War II veterans and peacekeepers as the technique of random sampling was not utilized (Rybash, Roodin, & Santrock, 1991). Thus, this research is not generalizable to the entire population of Canadian World War II veterans and peacekeepers. The purpose of life review though, is to hear and understand the individual's meaning of their experience and "the tendency to generalize may prevent us from developing understandings that remain focused on the uniqueness of human experience" (Van Manen, 1994, p. 22). -45-Second, a limitation of any study is the personal biases of the researcher. I tried to limit the influences of any biases in two ways. First, I always tried to be keenly aware of what my biases were, and second I had the participants critique my interpretation of their description of their experiences. Third, in contrast to the problem often encountered in quantitative research which is that the researcher is always looking for ways for the data to fit a particular theory a limitation of not fitting data into a priori theories was that I was confronted with a vast amount of unstructured data that I needed to sort without the guidelines of theory (Henwood & Pidgeon, 1992). Despite the challenge of sorting this data I feel that this qualitative method allowed me to stay closer and truer to the participant's subjective experience. - A final limitation of any ethnographic study is concerns raised by social desirability on the part of participants. Social desirability refers to the tendency of participants to respond in a manner they perceive to be socially desirable to the researcher (Davison & Neale, 1994). I feel that this potential limitation was mitigated in group and in follow-up interviews by creating a safe, respectful and non-judgmental atmosphere where participants could express their true thoughts and feelings without feeling judged. -46-CHAPTER FOUR — RESULTS This chapter contains the biographical synopses of the ten men who participated in this research. Each participant is identified by a pseudonym. True to life review, each "story" focuses on what each participant chose to share in the six sessions. This means that different synopses may focus on different themes. Some synopses focus on the group members' careers, whereas other are almost mute on the point. Some focus on the group members' family of origin, whereas others focus on the group members' present day family. It is all about how each participant chose to tell their own story. Each synopses though, focuses considerably on the group members' military experiences. This may be because their military experience had such a significant impact on these mens' lives or it may be because this was what the ten men in this group had in common. Perhaps both of these were contributing factors. Following the mens' biographical synopses are the themes identified through this research. The meaning of each theme is supported by quotes from the participants. Biographical synopses George's biography George is a retired salesman who volunteers in his community in many capacities. One of his accomplishments that he is most proud of is that he used his skills as a salesman to raise money to have a church built. His biggest involvement though, is in veterans' organizations such as the Royal Canadian Legion. For many years he held -47-executive positions in this organization. George is 82 years old but remains very young at heart. He has a sharp wit, a tremendous sense of humour and an infectious laugh. He states the he uses humour to cover up much of the tragedy that he has seen in his lifetime — the depression, two wars and so forth. George's father had been a veteran of World War I and later a police officer. George remembers hiding late at night listening to his father and his friends tell war stories — both the good and the bad. He went to England, himself, in 1936 to join the Royal Airforce, later being transferred to the Royal Canadian Airforce when Canada joined the war. Much of George's service was in the Middle East; particularly Egypt. What George remembers most about the war was the sad and tragic consequences of war on children. George takes considerable pride in having been married for 55 years. His wife is also a veteran and described by George as his best fiend. Having been an only child, this relationship took on special meaning to him from the start. His wife helped him considerably when he returned home from the war. George states that he had a really hard time integrating back into society. He did not feel he could trust people who had not been in the services. He was also very sick shortly after his return. He was struck with spinal meningitis and could not walk. He states that it was then that his wife had the biggest influence in his life and in his career. She made him get out of bed when he could not get out of bed. And she kept making him get out of bed until it got easier and easier. -48-His rehabilitation was slow but it is doubtful that it would have happened at all had it not been for her. Today, George has many children, grandchildren and great grandchildren. He derives a lot of pleasure and pride from his family. Despite some regrets in his life he states, "If I had to live life over again I wouldn't change a thing." Robert's biography Eighty-one year old Robert was one of 11 children. He remembers being very poor and all family members having to pitch in for the family to be fed, clothed and sheltered. Robert states that it was largely his mother and sisters who shaped him — particularly his older sister, Ann. He also remembers being discriminated against because of his Ukranian heritage. When Robert speaks of his past it is evident how hurtful this early prejudice was and still is for him. He speaks with some anger of family members who rejected their Ukrainian heritage to fit in and be more accepted by others in the community. Robert started grade seven but never finished. He states that that was how things were in those days. His help was needed at home. One had to work to survive as it was the depression years. Robert got his first paid employment at 15 and left home at 17 years of age. By that time he was already a "jack of all trades." Robert volunteered to go to the war in Spain but was turned down because he was only 17. He did though, serve in World War II which was a traumatic experience for him. -49-First he witnessed the horror of D-Day and not long afterwards the tank that he was in was blown up. His three buddies in the tank died. Robert was the only survivor and he vaguely remembers wandering in a daze for a few days until he was eventually taken Prisoner of War (POW) by the Germans. He remained a POW for almost a year and then spent time recuperating in England before returning home to Canada. Robert never expected to survive. Robert had always wanted to farm so upon returning home from the war he found, fell in love with and married a farm girl. She was also Ukrainian. The only problem was that she had farmed her whole life and swore that she would never farm again. Robert therefore went into logging and eventually owned his own small lumber mill in the Southern Caribou. He states though, that he was a little too soft-hearted for business and tragedy struck when his operation burnt down. Being down and out he went back into logging. Ironically an analogy that Robert often used in the group was that when times get tough one has to "rise from the ashes." Robert had literally risen from the ashes to get on with his life after his mill burnt down. Today Robert describes himself as having a strong sense of family with his wife, children and grandchildren. This is evident when you see them together. Their oldest daughter was adopted and Robert states that she was probably the most important thing that ever happened to his wife and him. Watching her grow strong and trusting rebuilt much of the trust that his wife and him lost over the years. It helped in healing their -50-wounds. Robert is also a recovered alcoholic and further describes joining Alcoholics Anonymous in 1953 as a lifesaver. They have been very supportive to him over the years as his family has been. Gregory's biography At 79 years of age, Gregory has lived what most would describe as an exciting and adventurous life. He was a pilot both in the forces and in civilian life for almost 45 years, retiring from flying at age 66. He states that he still gets a charge hearing an airplane open up on a runway. Gregory was born in Nova Scotia and was one of three boys. He describes himself as being close to both his brothers. He grew up with no extended family around and regrets that he also raised his own family this way when he moved them all from the East to the West Coast. Gregory has been married 53 years and has six children. He states that he is closest to his youngest daughter. His youngest son died a slow and painful death a few years ago and this has been very hard on the whole family. He further states though, that the whole family supported one another through this tragic event. As Gregory has gotten older he finds that he has developed a real appreciation for the "spirited way" of servicemen's wives. They took on all the home and family responsibilities and he now realizes that this was no small undertaking. Gregory's father had been a World War I veteran and both Gregory and his older -51 brother signed up for World War II. They went overseas together. Gregory was a mere 19 years of age. After a very short stint in the army he got himself into the Airforce and started his 45 year career as a pilot. Gregory was there on D-Day and remembers it as quite a sight. He then went on to serve in the Korean War and as a peacekeeper during the India/Pakistan Conflict. He states that his reasons for serving were largely self-serving. He wanted to fly. He was not out to correct the evils of the world. Gregory states that the major decisions in his life were to stay in the Airforce after World War II (he postponed his re-entry by 23 years) and to marry. He states that at nearly 80 years of age success is really your career as a father and if he could live life over again he would spend more time with his wife and family. After retirement Gregory became active helping out people with multiple sclerosis. He volunteered in a pool program and thoroughly enjoyed getting into the water with the clients. He retired from this work after five years but because he did not want to give up the time in the pool, he then got into seniors competitive swimming. He quit this when his younger son became ill so that he could spend time with him. Today Gregory is involved in a model train club, is enjoying his retirement and his family. Raymond's biography Raymond is a 74 year old retired pharmacist. He describes himself as having been close to both of his parents and continuing to be close to his siblings. He has been married 50 years and has three daughters and one son. His immediate family is close and -52-took care of him after his stroke a few years ago. Raymond served in the armored corp during World War II and spent most of his service time in the Pacific. He enjoyed his service and is very grateful for the opportunities that being a veteran allowed him. After the war the Department of Veterans Affairs put him through university — something his family would not have been able to afford. Raymond went into pharmacy as his father had been a pharmaceutical salesman. Raymond states that he was also fortunate to link up with a strong mentor very early in his career. The first senior pharmacist that he worked under lead by example and was always willing to share his knowledge. Raymond felt that this gave him a good solid foundation for the rest of his career. He also made sure that young pharmacists that apprenticed under him in the following years were treated with the same care and respect. Raymond worked for a number of drugstores in his early years but eventually owned and operated his own store for 27 years before eventual retirement brought on by a stroke. A large part of Raymond's career though, included his work in the community. He sat on the first hospital board formed in Maple Ridge and was one of the citizens who pushed for, and eventually saw, a hospital built in the same community. He continues to volunteer for the St. John's Ambulance and is active in the Stroke Club. When asked why he volunteers so much in his community as his own health is beginning to fail him, Raymond states that he feels this is part of being a well-rounded and complete person. -53-Taylor's biography Taylor has overcome a lot of hardship and tragedy in his lifetime and at 73 years of age he believes that this is what has shaped him into the strong individual he is today. It could also be said that this is what has shaped him into the compassionate individual that he is. Taylor was orphaned at seven. As a child he had no real confidants and managed things on his own. He remembers it being the depression years and things being tough on everyone. He believes that this early experience in his life gave him a good foundation for survival. As Taylor's uncle had been somewhat influential in his life and a World War I veteran, Taylor joined up to fight overseas at 17 years old. He quickly got into the Airborne and vividly remembers parachuting in on D-Day. Taylor describes his wartime service as the most memorable and best thing that he ever did for himself. The downside was seeing friends die, a memory that still brings tears to his eyes 50 years later. Taylor has had three careers in his lifetime. For 26 years he was in the army, for 17 years he served for British Columbia Corrections mainly doing lay counselling and at present his career is volunteering in many capacities in his community. He sits on the Board of Directors for the Abbotsford Bingo Charities and for the Schizophrenic Society of Canada. He is also very active in the Airborne Association organizing meetings and conventions and writing articles and poems for their newsletter. -54-Aside from taking great pride in his military service, Taylor also takes pride in having raised a good family and having gone back to school to take Criminology courses at university at 55 years old. Graeme's biography Graeme is a happy, positive individual. At 65 years of age he has never married but has always been very close to his family of origin. He was the main caregiver to his sick, blind mother until her death in her 90s. Graeme was the youngest child of four children. As he was the youngest and the only boy he describes himself as being somewhat spoiled. His one sister died when he was 12 years old and she was 17 years old. This was the first event that really brought the family together. Since then the family has been there for Graeme through his cancer, heart attacks and heart surgery. He had heart surgery in 1974 at the age of 40. He had just retired from the services and attributed much of his heart disease to the stress of his last few postings (long hours and many critical incidents). Graeme joined the army at 17 years old. He was a bit too young to go over to Korea and this was a major disappointment for him. After completing his medic training, he completed a 13-month tour in Egypt. He vividly remembers to this day his first postmortem and although he describes himself as becoming hardened to medical incidents, postmortems were always difficult for him because in the military community everybody knows one another. -55-Today Graeme keeps himself busy. He is an avid reader. Both of his parents were well educated and passed their love of books onto him. He collects many different things, is involved in a camera club and spends much of his time hiking outdoors. He continues, he says, to always look on the bright side of life. Reg's biography Reg was born and raised in Quebec. At 47 years of age he still looks back fondly on his French Canadian upbringing. He describes his family life though, as tough. His father was harsh and critical and relied on Reg to be a breadwinner for the family, forcing him to quit school at 15. After two years of hard work and little to no appreciation, Reg joined the navy at 17 to escape his home life. He missed his younger sister and brother; particularly his sister. She had always been special to him as she had been a premature baby and her survival had been tenuous for a while. Reg served throughout Canada and the world always working as a warehouse man on the ships. In 1984 he had the opportunity to serve with the United Nations in the Golan Heights. He took this opportunity and served there for eight months. He remembers this time with both fondness and sadness. What he remembers most vividly is that the Canadian contingent sponsored a Palestinian orphanage of 24 children. Each serviceman sponsored one child. Reg still remembers the little girl that he sponsored and to this day wonders how life turned out for her. He further states that when he got home he really appreciated his own kids — "they were lucky they had a father." Reg married early in life — at 19 years old. This marriage lasted 20 years and when it ended it was devastating for Reg. He now completely understands why his first wife left him. He had always put the navy first and his family second. He regrets never seeing his children grow up as he was always at sea. He expresses great pride in both of his sons and great sadness that one of them died in 1997. Since then Reg has married for a second time. He has married a psychiatric nurse and is approaching this marriage very differently from how he approached his first marriage. He has put his marriage first and his career second. Reg has been out of the navy for a little over a year now. He describes the transition between military and civilian life as hard. There was an understanding between military men and women that does not exist on the outside world. Reg misses this and keeps in touch with his navy friends as much as possible. He speaks of two betrayals in his life, though. The first betrayal was his father's betrayal. His father betrayed him by having no faith in him. The second betrayal was the navy's betrayal. In 1992 when his first wife left him nobody was there for him. He ended up in hospital for two and a half weeks with depression. When his major and supervisor came down to speak to him, all they could do was run women down and tell Reg how much better off he was without his wife. The problem was, at that time, he still loved his wife and missed her deeply. He found the navy's supposed comfort to him less than comforting. He found it insensitive. John's biography -57-John is a 42-year-old ex-reservist. He served in the reserves for over 20 years. This experience allowed him to engage in the adventurous lifestyle that he craved so much and probably would not have been able to find elsewhere. In 1976, at 19 years of age, John had the opportunity to do a tour in Egypt. This tour changed his outlook on life. He remembers just being a half year out of high school and having a machine gun shoved in his face. He knew then that life was not the same for everyone as it was for Canadians. The experience in Egypt was a real eye opener for John, and when he returned home from serving he remembers feeling considerable anger towards his friends who were preoccupied with what he saw as trivial matters, such as when they were going to get their next Unemployment Insurance cheque and so forth. In 1982 a life changing event took place in John's life. While on a training exercise with the militia he was in a serious motorcycle accident that landed him in a coma for two to three weeks. He states that he still experiences some short-term memory loss and is held together by steel. In John's words the accident wiped out five years of his life. It was in 1987 that he got back into the real workforce — first into trucking and then into the construction industry. John likes to work physically hard. Like everything in life John sees this 1982 accident like a coin having two sides — and up-side and a down-side. The up-side is that the hardship of the accident matured him and added a wisdom and strength to his character that he may otherwise not have developed. The down-side was that John had always wanted to be a pilot and had just -58-been accepted into pilot's school before the accident. Because of this accident, John was not able to pursue his education and hence his dream. He states that maybe being a pilot was never in the cards. Before the end of the life review group, John retired from the militia. He felt that " it was time to pursue other things in life. He continues to volunteer teaching the cadets and also helps with activities for the Association of Vietnam Veterans in Canada. Jim's biography Jim is a 27-year-old ex-infantry man who has recently married. He describes his wife as his soulmate. He is currently unemployed and trying to pull himself together emotionally before pursuing a second career. He is hoping that this second career will be in forestry. Jim was born on a reserve in Central Canada. He is of aboriginal heritage and the youngest of 15 children. His mother died when he was 13 years old. His two older sisters then took over raising him. He remains close to them to this day despite leaving home at 14 when his father remarried. Jim states that he was never close to his father and the combination of two large families (his fathers' and his fathers' new wives) was too much for him to handle. Two of John's brothers are now deceased and this has had a real impact on him as has his experience in residential schools. Jim was traumatized by what he saw while serving in Yugoslavia in the early 1990s. The pain and suffering of the elderly particularly bothered him — "to see them -59-looking through garbage cans for food was too much." He had come from a culture that shows great respect towards its elders to a culture that seemingly did not show any respect to anyone. Jim finds that he has lost much of his sense of humour since returning from overseas. He knows that it will be a long journey back to where he was before. A large part of the healing process for Jim has been his wife and his return to their native heritage. Through native teachings, arts and crafts, Pow Wows and sweat lodges Jim is slowly finding his place and some peace of mind. Shortly after the groups ending Jim and his wife returned to live on his reserve in Central Canada. He looked forward to going home, rejoining his family, returning to the land and getting a horse. Scott's biography Scott is a 34-year-old ex-Airforce personnel who describes his grandfather, a World War JJ veteran, and his wife as having the greatest influence on his life. In fact, it was his wife who convinced him to join our life review group. Scott is one of two children and describes his relationship with his sister as very close. She remains his best friend to this day. Scott remembers his parents as having an equal power balance in their relationship. He also remembers never doing without as a child. His grandparents taught him everything about the outdoors — hunting, fishing, and so forth. Scott's father was an alcoholic and eventually he split from Scott's mother. This caused a real rift and conflict in the family. Then his grandfather committed suicide in -60-1982. It was not a long time afterwards that Scott's grandmother died a horrible death to cancer. Scott states that it was these deaths and the substance abuse that brought the family down. He has' re-found family though, with his wife who he describes as emotionally supportive. Scott describes the socialization process in the Canadian Forces, particularly basic training, as so powerful that not only did it make him a different person, but he wonders if any of his other socialization matters at all anymore. Scott served in Sarajevo during the early 1990s. He describes it as a terrible experience to go into a country where life means nothing. Eventually Scott was hospitalized because of the results of trauma and stress overseas and returned home. Today, he is not able to watch or read news coverage of what is happening in the former Yugoslavia. Upon returning home Scott found re-entry into civilian life to be extremely difficult — "nobody told him that because of his experience he would be a different person." He describes the experience as one of being trapped between two worlds. He was fired from numerous jobs the first year after his return. After a settling down period he decided to continue his education and has now completed three years of a Social Work degree. He chose this field for two reasons. First, he knows from first-hand experience that people in pain need help and companionship. Second, school has taught him to put onto paper what his needs are. Scott is very involved in his schooling but still finds time to help newly returning peacekeepers with their re-entry experience. 60a SUMMARY OF FINDINGS Table 4.1 Benefits of Life Review (Birren & Deutchman, 1991) Benefit to Participant Number of Participants Reporting Benefit Sense of increased personal power and importance 1 Recognition of past adaptive strategies and application to current needs and problems 5 Reconciliation with the past and resolution of past resentments and negative feelings 2 Resurgence of interest in past activities or hobbies 2 Development of friendships with other group members 7 Greater sense of meaning in life 1 Ability to face the nearing end of life with feeling that one has contributed to the world 0 60b Table 4.2 New Outcomes/Benefits from "The Life Review Program for Canadian War Veterans and Canadian Peacekeepers" Benefit to Participant Number of Participants Reporting Benefit Formalization of one's reactions to trauma or to events (e.g. re-entry) 7 The receipt of specific advice, ideas or assistance 6 Engendering of hope 7 Relief or emotional release in telling one's story 9 Feeling heard/Being listened to 4 Relating/Commonality with others 7 New awareness or heightened awareness of one's contributions and/or abilities 4 New awareness of heightened awareness of others' contributions and/or abilities 10 Positive feelings obtained from others' responses to one's story 6 A new appreciation of one's life through comparison with other group members' lives 5 - 6 1 -Evidence of outcomes One of the best indicators of whether a program is effective or not is whether or not its participants would recommend it to others. When asked whether they would recommend a life review group to other veterans and peacekeepers, all 10 of the group members responded affirmatively. One group member had actually already recommended life review to a friend. Upon completion of the group both the process notes and interviews were analyzed for evidence of outcomes. This was to further test the groups' effectiveness. In addition to analyzing for outcomes listed by Birren and Deutchman (1991, p. 4) true to grounded theory (Glaser & Strauss, 1994) additional outcomes that also emerged from the rich data were analyzed. These new outcomes are listed below following Birren and Deutchman's and are indicted by an asterisk (*). Quotes from the interviews and group sessions are used to support the outcomes. Sense of increased personal power and importance One group member reported this outcome. Recognition of past adaptive strategies and application to current needs and problems Five group members reported this outcome. Of the five group members who reported this outcome, four were veterans. At one point in the group the five veterans were asked by a newly returned peacekeeper how they had done it — "how do you get -62-from one point — getting out of the military — to having a successful career outside the military?" The veterans spoke of things that had worked for them in getting through the war and through the depression. They also spoke of how these strategies and basic philosophies on life continue to work for them. Although at first they may sound simple and at times may even sound like cliches, there was no doubt from the veterans' testimonies that "keeping your hands busy and then your mind relaxes and gets onto other things... staying the course... never giving up, never letting yourself down... seeing life as an obstacle course and determining how to get around the obstacle course... discipline, discipline, discipline... confidence in yourself... taking it one day at a time... learning to size people up," and so forth can really work in addressing needs and problems. Concrete examples of where these adaptive strategies have successfully worked for a couple of veterans were for one veteran he found the ability to size people up, which he feels he learned during the war, continued to serve him well in his work in the correctional system. Another veteran, during his follow-up interview, was living his philosophy of "keep your hands busy and then your mind relaxes and gets onto other things." He was learning to use a computer to keep from focusing on his upcoming heart surgery. Reconciliation with the past and resolution of past resentments and negative feelings Two group members reported this outcome. One peacekeeper, when asked about his feelings in telling his story of a traumatic accident that he had been involved in during a peacetime training exercise, responded, -63-"It's like a circle... eventually at times of crisis the circle gets smaller. Time heals. Each time I go through it it is easier than the time before. Not as intense and painful." Later he spoke of no longer resenting individuals he saw as preoccupied with life's trivial matters such as unemployment insurance claims, weekend parties and so forth. He had had intense resentment towards these individuals immediately following his tour in the Middle East. Resentment and anger, when they first returned home, towards individuals who were caught up in the "small, trivial matters of everyday living" resonated for many of the veterans and peacekeepers in the group. Much of this anger and resentment seemed to be reconciled or resolved by the groups' end. This researcher believes that for some this reconciliation had happened before the life review group while for others it had happened during the group. I also believe that there was reconciliation on other matters but because a question concerning reconciliation and resolution was never asked at the final interview this cannot be stated with certainty. All that is certain is that two group members reported this outcome. I now see failing to ask a question around reconciliation and resolution as a shortcoming of this research. I feel that more than two group members experienced this outcome. Resurgence of interest in past activities or hobbies Two group members reported this outcome. -64-One peacekeeper reported learning patience from the group. He further stated that this allowed him to return to making breast plates, a native craft that takes considerable time and patience. Another group member stated that the written component of the life review rekindled his interest in writing about his life. This was something that he had been doing previously but had put aside for a number of years. Development of friendships with other group members Seven group members reported this outcome. Close friendships developed between some of the group members. Following the group's completion many of the group members continue to visit each other and have get togethers, such as lunches. These friendships developed quickly and seemed to emerge from common experiences. One peacekeeper summed it up this way; I think that there was some bonding in it. There was three generations there — I was actually in the middle one. And you saw what the newer generation was doing. Like I was too young to really understand the older generation when the war ended. And I think that there was a bonding with the three really... It was a good experience... Raymond and I talked on the phone as if we had known each other for years. That usually with someone you have met with so few times you don't find that. On the last night of the group one peacekeeper brought the two group leaders and all the other group members native crafts that he had made. He stated that these gifts were given as a token of his friendship. Other group members responded that they would cherish their gifts as a gift from a friend. Most impactful to this researcher though, was phone calls that I and other group -65-members received last Christmas. A group member who had moved away from British Columbia and was back in town to visit family made the effort to call all the group members to say hello and see how everyone was doing. Generally a phone call does not hold such significance but before taking part in this life review group this particular group member reported closing himself off from others due to psychological distress caused by his peacetime service. Greater sense of meaning in life One group member reported this outcome. Ability to face the nearing end of life with a feeling that one has contributed to the world No evidence of this outcome. This researcher was not at all surprised that the findings demonstrated strong evidence of only two of the seven outcomes listed by Birren and Deutchman (1991). Birren and Deutchman's evidence of outcomes is documented in their book, Guided Autobiography for Older Adults where this intervention is again used only with the elderly who Butler (1963) had proposed would have a realization of their approaching death. Men aged 30, 40, or 50 probably would not have such a realization. The "ability to face the nearing end of life with a feeling that one has contributed to the world" would be an unlikely outcome for middle-aged and young men. Ironically though, the men in this particular life review group who were in their 70s and 80s did not seem to see their -66-lives as nearing an end either. * Normalization of one's reactions to trauma or to events (e.g. re-entry) Seven group members reported this outcome. The experience of normalization appeared to be most therapeutic for the peacekeepers in the group. This seemed to be because their experience with trauma and their difficulties with re-entry were more recent than they were for the veterans. They are presently questioning whether or not their reactions are normal. Although a few of the veterans also benefitted from normalization while participating in the group for the most part the role that they seemed to serve was to validate the peacekeepers and the peacekeepers reactions to war and re-entry. This was evident in one peacekeeper's follow-up interview when he stated; .... to hear their experiences and to then be able to make correlations from their experiences to my own was you know I'm actually normal; I'm O.K. and I'm functioning very well relative to other people... I drew lots of correlations — when they were talking about difficulties with jobs or what they wanted to do or where they were going to go and looking at people and knowing that they really had no idea what the war was about. I could relate to all that. He elaborated further, saying; Well I think anytime you come into contact with other people, have other people's experiences, they become a bit of a part of you depending on what you take on. So far I think for me, like what I was saying before, was having the contact with the older people that I knew kind of a slang term, "were in the know" and looking at me and saying "hey, it's okay, this is completely normal"... it was like a very profound normalizing effect for me. I came back feeling lighter every week. It felt good. -67-Another peacekeeper also spoke of this normalizing effect when he said; We went through the same kind of... sometimes the same horror that we've seen or the same miseries or the same joys and all this. Myself, personally, I wasn't involved in an actual combat situation, but I saw the aftermath of some of the combat that was involved and some of the miseries that was part of it and how it affected me and how it affected the other individuals at the same time. There was a lot of similarity. The therapeutic effect of this normalization was not only noticed by the group leaders, but also a few of the veterans. When asked whether or not he felt he was able to pass on any information or coping strategies to the younger peacekeepers who participated in the group, a veteran responded, "You mean did they listen to us... well I don't know if they got any ideas from us but I do think they had realized that it had happened to other people and it wasn't just them." * The receipt of specific advice, ideas, or assistance Six group members reported this outcome. As mentioned previously in this thesis this researcher expected that this would be a significant outcome of this particular intergenerational group. Fewer group members than had been anticipated reported it as such. Six group members did report it as a benefit though. Overall, it was the veterans who provided advice, ideas and assistance to the peacekeepers. One peacekeeper, who retired from the Navy two years ago, stated, "I know that Taylor gave me a few ideas and all that about trying to get more involved — try to get my warehouse certificate because that's one thing here that they ask in B.C. And I was very pleased about that. Grateful about him trying to help overall." Other -68-advice, ideas and assistance centered around education and also around how to apply for programs and benefits from Veterans Affairs Canada. Perseverance was stressed and the veterans used themselves as examples of individuals who had successfully made it through the bureaucracy. * Engendering of hope Seven group members reported this outcome. Engendering of hope was a more significant outcome than the actual receipt of specific advice, ideas and assistance. What made this outcome more significant was not so much that one extra group member reported it as such but the passion in which the group members spoke of it — something that has great significance in qualitative research. One peacekeeper spoke about how the group had confirmed for him that the path he is taking in life has worked for others and can work for him. When asked if he had received any information or ideas from the older war veterans, he responded; I said 'I'm sitting across the table from you people and you're 40 years ahead of me and I wanted to know how you did it'. I don't know that if really anything specific came out to help me. What I saw was that the people that re-educated themselves and made like a forceful re-entry into society, which I believe is what I'm doing, were better off 40 years later. And there were some people that floundered and... I don't blame those people for that because I can't even imagine what they went through but it just seems to me that the people that made a conscious decision — one of my values is a conscious decision to do what's right or 'do the right thing' is what I always say and I was looking at some of the older veterans, the World War II veterans and seen that they made, the ones that I felt made a conscious decision to do what was right at the time whether that be re-education or there was a whole myriad of things... didn't take the easy way out, were a whole lot healthier and happier 40 years later, sitting in front of -69-me after the fact. It confirmed for me that what I am doing is what I should be doing, it confirmed for me that it has worked for a lot of other people. Another young peacekeeper spoke of his depressive episodes not occurring as frequently; Well I 'm actually a lot calmer and I have more patience like I said, but my wife would probably tell you that, but she's not here right now. I've changed in a lot of ways. I feel a lot better about myself and.... um the depressions are not as frequent. One veteran spoke of a rebuilding of trust, while another spoke of his faith in human nature being restored. * Relief or emotional release in telling one's story Nine group members reported this outcome. During the actual group sessions themselves, it was obvious that for the peacekeepers there was relief or emotional release in telling their stories. One peacekeeper simply and succinctly put it, "I came back feeling lighter every week. It felt good." Another stated, "Before it was not a thing for me to talk about all my experiences that really bothered me. But it is good therapy to talk about it and have someone to listen to it. It is good." In the follow-up interview this same peacekeeper went into further detail stating, "Oh yes, definitely. For me it is good therapy to talk about it. Y o u keep it inside and it's going to eat you and that is when you're going to turn over to something else — drugs and alcohol. And I can talk to you about that from experience." He later went on to say, "... and don't wait 50 years — should talk about it as soon as they come back. And even talk about it in the theatre itself." Although not pleasant, the analogy he -70-used was most apropos — "if you keep garbage it will rot, and it will smell. So you have to get rid of the garbage. Dump it. Got to get rid of it — once a week, once a month." Another peacekeeper talked about the relief not only in telling one's story but in having others hear it and comment on it; And when I read it out loud it felt like it was taking a part of it off of me actually and the reflection and feedback from the other men was actually good because like they were World War II veterans and they were fighting for the world... but what they said about my job as a peacekeeper was that they had more respect for peacekeepers... hearing that made me feel a lot better. This same peacekeeper later stated; Ya, I feel a lot better about it because when you come home you're wearing your uniform and all that and you got your medals on and people walk by you and they kind of snub you because what they see on T.V. is totally different than just a straight view of it... and I've been called a murderer before at the airport... the Somalia affair and everything else. I had a hard time dealing with that but I kept it inside of me until now actually. Again another peacekeeper simply said, "Thank-you for asking me to come here so I could find out why I needed to be here." For the peacekeepers the emotional release in telling their stories was not only evident to the two group leaders but also commented on by a few of the veterans. One stated; The majority of them (referring to the peacekeepers in the group) had problems that had seemingly been unsolved but after about three weeks discussion, or three meetings should I say, they were not entirely different but were certainly different from the way they had been when they first walked through the door. - 7 1 -It was not only the peacekeepers though, who experienced emotional release in telling their stores. The World War II veterans also experienced this. The Prisoner of War (POW) in the group said in his final interview; ... like I was saying in my case, I had broke away for a long time and it felt pretty good to have the chance to get in there and discuss and hash it over with somebody who's not going to criticize you, make a joke of it, and you really don't have to confirm everything... it's my opinion you don't like to be laughed at or made a joke of and have to confirm everything that is said... why did you do it? When did you do it?... you get away from that judgement. The group leader also drew to my attention that the four veterans who participated in the veterans only group the summer before, were far more open in their expression of feelings in this intergenerational group. He also stated that they were more inclined to talk about negative aspects of their war experiences and not just the positive. Witnessing the peacekeepers express negative emotions seemed to lessen their bravado. One veteran confirmed the leader's observation in the follow-up interview when he stated, "Seemingly they're listening to us and that's I think, you will recall, we opened up much more than we'd been in the first set-up (referring to the veterans only group) because all of a sudden these people are listening to us... you were listening to us." * Feeling heard/being listened to Four group members reported this outcome. One veteran and one peacekeeper expressed relief in being heard by the other group members. They tied this relief in with feeling heard or listened to — "seemingly -72-they're listening to us... we opened up much more," "they don't have to confirm everything." Others also talked of feeling heard or listened to; It's a human thing to express feelings and the way to express them is to talk about it. To talk about it and have someone to listen to it. Not someone to just shake his head... They could feel it. I could feel what they were saying and they could feel what I was saying... There was a sincere 'Yes, I know what you are talking about'. The sincerity was there. * Relating/commonality with others Seven group members reported this outcome. Hansen, Owen and Madden (1992) in their book Parallels: The Soldiers' Knowledge and the Oral History of Contemporary Warfare found that veterans' experiences were eerily parallel. This was regardless of the theatre of war that they served in or the soldiers' nation's political objectives. They write of being struck by the extent to which parallels span ethnic, gender, and national boundaries (p. 3). After witnessing this intergenerational group I would add to Hansen et al's list generational boundaries. One young peacekeeper commented that despite all the differences between the veterans' and peacekeepers' experiences there were many similarities; Again, when we started to talk about the re-entry phase that's where I saw the similarities. Before the, I, I'm partially biased, I would never want to say that my service was even close to what they did. It's a different world, different parameters, different things happened, a different reason for serving at the time. So ya, but the re-entry part of it, there was a lot of correlation — the difficulties, the isolation, the marginalization, you know the jobs, the interrelationship problems, all of it... and you know, I drew lots of correlation between what the older guys were talking about — you know -73-difFiculties with jobs, not knowing what they wanted to do, or where they were going to go or that they were looking at people and knowing that they had no idea really what the war was about. I could relate to all that. Another peacekeeper who had expected that there would be considerable differences between the veterans' and peacekeepers' experiences also commented on the similarities; I thought there would be a big difference in the... some of the stuff that we went through and then at the end of the sessions there was not much difference for me per say. We went through the same kinds of... sometimes the same horror that we've seen or the same miseries or the same joys. Another peacekeeper who was a medic and who in the beginning felt that not only did he not have a lot in common with the war veterans but that he also did not have a lot in common with the newer peacekeepers, commented; You heard their experiences and you thought it is not so dissimilar from mine and yet we were in two different situations. Like I can see these newer peacekeepers like Jim, Scott, and John the traumatic things they said they went through, they were in more of a conflict than I was. They saw the atrocities first-hand where there wasn't that carnage during my... my, my traumatic experiences were accidents — someone being blown up by a mine or a car accident or something like that. And perhaps most surprisingly was the commonality commented upon by the reservist as the experiences of reservists are often thought to be quite different from that of full-time enlisted personnel. He stated; I remember sitting one night and reflecting on our sessions and things, 'oh my God there is so much that I can relate to these guys because the reason that I joined the militia and went overseas and did all these other things was spirit of adventure'... It can get you killed. It was not only the peacekeepers who noticed and commented on the parallels or -74-commonality between all of the solders' experiences but also a few of the veterans. In speaking on the similarities between veterans and peacekeepers one veteran commented; With two of them (referring to two peacekeepers in the group) the children bothered them. I know that as far as I was concerned too this is what bothered me. I shouldn't say that, I didn't care about the mothers and fathers but the little kids didn't understand what was going on and why they were sleeping on the ground... and this bothered me because we had little ones... Another expressed comfort in talking amongst others that share in, and therefore, understand his experience; I find like talking amongst a group, amongst soldiers. You see, you can talk to them because they can relate to... but somebody that hasn't experienced that they can't... it doesn't make sense. You have to start way back. Explain it all. It can be a long drawn out affair. Another veterans, in drawing parallels between the two groups of soldiers, simply stated, "We both feel that we lost a lot of ourselves overseas and we are both healing." As a co-facilitator in this group it was the healing component of this relating or commonality with others that excited me the most. To hear words like; For me it was beneficial. It was definitely a plus. It made my story diminish in significance compared to the problems they encountered... how throughout the six sessions there was a growing bond in the group because we had all done basically the same for Queen and country. Definitely beneficial. A good life experience to be able to work with others in a parallel situation. And to hear another group member state, "... talking about it helps instead of keeping it locked inside because nobody understands unless you talk to a veteran." This same peacekeeper later commented in the follow-up interview, "I guess it was... a lot of people -75-not understanding what a soldier goes through. Actually there is kind of like a peaceful bond between soldiers actually that have been in combat and stuff. They actually know what each other is going through and how the eyes click..." I later asked this peacekeeper what "the eyes clicking" meant, to which he responded it was the blank stare that came over a soldier's face when talking about things, often things totally unrelated to war, when another soldier knows he has gone back to that dark place. This reminded me of Herr's (1992) definition of abjection — an omnipresent "something" — oppressive, crushing, profoundly significant — for which there are no adequate signifiers. It is the responsibility associated with what you see that stays stored in your eyes. Shared experiences, similar reactions, common themes popped up over and oyer again in the actual group sessions. Things like black humour, substance abuse, a sense of futility, a sense of fate, suicidal ideation and so forth. For every story, experience and feeling there was another soldier or more who could relate. One veteran laughed, although listeners were left with the impression that he did not think what he was saying was funny, when he talked about his experience of landing on the beaches of Normandy on D-Day — "we trained for this for a year, only to make it 500 yards." The futility was also evident in another veteran's words when he said, "In war no one wins; even the winners lose" and in a peacekeepers words, "Was it worth it? We went to the Golan Heights thinking we could make a difference. We didn't." There was also a questioning of fate. A peacekeeper spoke of the driver replacing him in Egypt being killed. He stated -76-that had this happened a few months earlier it could have just as easily have been him. A veteran responded to this story telling how he had crawled out from under two dead bodies that fell on top of him. He had landed in the bushes and had lived. * New awareness or heightened awareness of one's contributions and/or abilities Four group members reported this outcome. If this research study had been quantitative in design, and not qualitative, this particular outcome would not have been considered significant. This researcher found it to be significant though, because although only four of the participants reported it as a benefit, for one of the participants this outcome seemed quite profound. Usually quiet in group, this rather modest veteran with 30 years of military service including two wars and one peacekeeping tour, stated in one session; .... I never took any particular pride in that kind of thing (referring to his military service) but after going through this little session I thought, well maybe I do have something to be proud of— I wasn't the number one ace fighter pilot but I thought, 'well it was done in a good attitude'. And I'm not blowing my own horn... He later elaborated on this in the follow-up interview saying; What happened for me was a self-examination. I started thinking about my experiences during the war and rehabilitating and so on and I had never thought very much about them except that I didn't regard them as great success stories. When I look back on them and listen to these other guys I think I didn't do too bad. It gave me a... I guess a look at myself that I haven't undergone for years. Ya, it had a good effect on me in other words. I got a better appreciation of what the peacekeepers do and perhaps a little better understanding of my own life. One peacekeeper also expressed this new appreciation of himself stating in the follow-up -77-interview; ... but what they said about my job as a peacekeeper was that they have more respect for peacekeepers and hearing that made me feel a lot better because I wasn't too sure what the men would think about peacekeepers now as opposed to World War II veterans, Korean veterans and all that... * New awareness or heightened awareness of others' contributions and/or abilities All ten of the group members reported this outcome. Before the group started all the peacekeepers, like the most of the rest of society, were well aware of the contributions of the World War II veterans — if not on an individual basis at least on an overall basis. The same though, could not be said about the peacekeepers' contributions. By the group's end the peacekeepers' contributions were not only known and understood but also acknowledged, appreciated and respected by all group members. The effect of this was twofold. First, it left some of the peacekeepers with a more positive feeling about themselves and second, it left some of the veterans with a sense of having to do something to help the peacekeepers. It politicized a few of them to the issue. This new awareness was expressed in words such as the following from a veteran; I was amazed at the variety of speeches that came up. Everyone had different experiences. Especially the stories of the occupational groups (later clarified to be the peacekeepers). Used to believe that Canada's involvement was a waste of time but not anymore... after listening to their stories you have to give them a lot of credit for staying in there and putting up with that... courage enough to go in there and start probing — for others; not for yourself. You have to be courageous to do that... inspires you. There are still people around who do things for humanity — do a little extra. Two other veterans echoed similar sentiments. One commented, "Well to me it was an eye opener to the difficulties of peacekeepers... one of the things we had that these guys don't have is public appreciation. Everybody was glad to see us but for these guys I don't think it can be quite so stimulating because they don't have the support; at least the visible support." The other stated, "I was never sold on the peacekeepers but with these guys I found out what peacekeepers do.... I was very impressed." Later in the follow-up interview he elaborated on this further saying; Well for me it was an eye opener to the difficulties of peacekeepers. I never — I thought that it was well a less than soldiery job. My own experience with peacekeeping in India was one of interesting excitement and not very threatening but these guys when I listened to them and realized what they had put up with, it was an education right there, a different slant on it. So if you could covey that to the world that would give us an appreciation. This same veteran also had a heightened awareness of his wife's contribution in taking care of the home front while he served his country in two wars and one peacekeeping mission. He often spoke of the "spirited ways" of soldiers' wives and commented that listening to the other men talk about their wives caused him to have a greater appreciation of his own wife. * Positive feelings obtained from others' responses to one's story Six group members reported this outcome. With this outcome it did not seem to matter if the story was in the distant past, as in the case of the veterans, or in the more recent past, as in the case of peacekeepers, having other respond positively to one's story seemed to generally result in positive -79-feelings for the storyteller. One peacekeeper phrased it this way; ... and when I read it out loud it felt like it was taking a part of it off of me actually and the reflection and feedback from the other men was actually good because like they were World War II veterans and they were fighting for the world... but what they said about my job as a peacekeeper was that they have more respect for peacekeepers... hearing that made me feel a lot better..." A World War IIPOW spoke of rarely talking about his war experience. He reported that the last time he spoke in depth of his experiences during the war was with a minister in the 1950's. This group allowed him an opportunity to talk about this part of his life again. He reported positive feelings as a result of this; Oh ya... well because in my case I had broke away for a long time but it felt pretty good to have the chance to get in there and discuss and hash it over with somebody who is not going to criticize you or make a joke of it. * A new appreciation of one's life through comparison with other group members' lives Five group members reported this outcome. A process of comparison occurred for several participants. Some group members reported this as beneficial as it served to put their own lives into perspective. Often it made their own stories seem less tragic. One group member in his follow-up interview phrased it this way; For me it was beneficial. It was definitely a plus. It made my story diminish in significance compared to the problems they encountered... listening to the other chaps getting your significant problem is not as significant as you might think it is. There's other people out there who are in pretty much worse shape than you are. -80-This sentiment was echoed by three other participants. One peacekeeper stated; For me I thought it was hard when I saw the stuff in Israel and Syria but to see the actual suffering and I mean the carnage and all that which I did not see that much in the Middle East... I can see why these guys are really affected by that and I hope that there is more done on this. A veteran expressed something very similar when he stated, "After listening to their stories and stuff it was those guys were worse off some of them than we were." This process of comparison did not always revolve around the service part of the participants lives as demonstrated by one veteran's words; Well again it made me realize that I was pretty lucky in this world. There were a couple of orphans there — the one guy had dreadful experiences with his parents or lack of them, he was in a foster home or a foster child. Their experiences were pretty darn rough and I thought, 'boy I had a good upbringing'. So again with further self-examination, I came away with a feelings of, T did better than most. Not bad at all'. Exploring the questions At the start of this research study, four questions were posed. They were: 1) What are the specific competencies, skills and knowledge needed for successful re-entry into civilian life? 2) Can these skills, competencies, and knowledge be successfully passed on in an intergenerational life review program involving both World War II veterans and peacekeepers? -81-3) Will the intergenerational passing on and receiving of these competencies, skills and knowledge lead to increased feelings of efficacy on the part of both World War II veterans and peacekeepers? 4) What changed for individuals during the course of the program and do they view their lives differently after the guided autobiography/life review experience? The question now is whether or not these four questions have been answered. In regards to questions one and two, six group members reported either receiving from or giving to other group members advice, ideas, or assistance. Some of their specific comments have previously been listed. Seven group members also reported normalization of their reactions to trauma or events and seven group members reported an engendering of hope. As to whether or not this intergenerational passing on and receiving of these competencies, skills and knowledge lead to increased feelings of efficacy on the part of the World War II veterans and peacekeepers this is more difficult to answer. Most certainly the group members reported feeling good, relieved, more positive, less depressed and so forth upon the group's completion, but as to whether or not they felt more competent or effective this is difficult to say. They expressed though, positive feelings in having other listen to them or in having others affirm for them that the path that they are taking in life has worked for others. These are generally a part of feeling competent and effective. As for the fourth and final question, "what changed for the individual during the course of the program and do they view their lives differently after the guided -82-autobiography/life review experience?" I defer to one of the peacekeeper's comments. He stated, "Well I think anytime you come into contact with other people, have other peoples' experiences, they become a bit of a part of you depending on what you take on." I agree with this peacekeeper when individuals talk and listen to others in such an intimate manner, as this group allowed, they will change. These ten group members' changes have previously been reported in the outcomes section of this chapter. Included amongst them are a feeling of being normal, a more positive, hopeful outlook, friendships, relief and emotional release, a new awareness or heightened awareness of one's contributions, and so forth. Comments on writing, reading, and feedback process (the guided autobiography method) Six of the group members found value in the guided autobiography method used in the group. The other four found value in getting together as a group but felt that any group format would have been beneficial. One benefit of the guided autobiography method reported by a few of the participants was the opportunity to be reflective. One group member, who has had a stroke and reported at time needing extra time to put his thoughts together and be reflective, put it this way; ... great to have that and go home and think about it for the week. And I think that you will find that we all didn't leave it to a half hour before... I looked at it everyday — maybe more than once — and I used to put it off to Saturday and I would make the odd note on a piece of paper. And then on -83-Saturday I would sit down and I would do stuff and then I used to like to do it Saturday or Sunday because this was stuff that I would scribble and then I would redo it... You can think about these things and get your thoughts organized. Another member stated; I think it was a good thing because you said what you wanted to. You established a theme there and they could ask you questions... And they could ask a question and you could elaborate on what you had said. Several group members commented on the writing aspect of the guided autobiography method. Some spoke of it as an accomplishment and others talked about the feelings it would often bring up for them. One veteran stated, "I would say I've written about myself more in detail and I elaborated on it a little bit more. I have more of a history." Later, when asked what he intends to do with his writings now, he responded, "I kept them all — the paperwork. I review them." Further regarding the writing one young peacekeeper reported difficulties with it stating, "But writing it down, trying to remember, bringing it all back... made me really angry a lot. But when I did that I just put the pen down and went for a walk by myself..." He reported though, the next steps in the guided autobiography method to be therapeutic, "... and when I read it out loud it was... it felt like it was taking a part of it off me actually. And the reflection, the feedback from the other men was actually good because they were World War II veterans..." Another peacekeeper, who works a couple jobs to make a living, admitted that he was not always able to come to group with his written homework completed — "on the writing aspect I know that I fell down on my commitment because of my work schedule." When probed -84-further as to whether or not he noticed a difference in the quality of the experience when he was able to find time to write, he commented, "I liked the writing... the discipline and planning of writing. It is definitely beneficial to enhance the meaning of these sessions." A couple of other group members reported other benefits or aspects of the guided autobiography that they appreciated. One simply liked the fact that it was not hierarchical in nature stating, "When I'm involved in group or these type of things I like to see where there's not a head, a King or a Queen out front and everybody else is upon and what I found with the reflecting part of it, especially when people were giving feedback was that when somebody was speaking they were the chair... And it facilitated people opening up more too." Another peacekeeper reported learning patience through the process of having one group member tell their story at one time — "The group taught me patience too actually cause sitting there and listening to everybody else's stories and then I was thinking of what to say, what to bring up with my themes and that and writing them down — actually putting them on paper was one of the biggest things I have accomplished." Recommendations from group members In the follow-up interviews all group participants were asked if they had any ideas or suggestions about how to make a group like this more effective. Making the life review program longer was suggested by a number of participants. Ironically, the time frame of six weeks was initially chosen as the veterans and peacekeepers were not sure that they could commit to a 10 week program. At the end of six weeks though, most of -85-them expressed a strong desire to continue on as a group in some form or another. They did not want to stop. A few participants also suggested making the group smaller. This had been this researcher's original intent. Initially 10 group members were contacted and asked to participate in the group as it was thought that a few would come check the group out and decide not to participate or would drop out after a few sessions. This is not uncommon in group work. Instead each member came for the whole six week duration and a few even asked i f they could bring friends along. This resulted in the group being larger than it probably should have been. Ideally, with three to four hours of storytelling and discussion time each evening, the group should have had five or six members at most. At times it did feel as i f we were rushed. The most important lesson that I learned though, in co-facilitating this group was that pre-group screening or interviews are a must. There was one peacekeeper participant who in the beginning of the group was experiencing quite a lot of emotional difficulty and although I would not necessarily have wanted to screen him out of the group, I would have liked the group leader and myself to be more aware of his situation at the onset. Ironically, it is my belief that it was this group member who got the most out of the life review. Other suggestions made by group members were the inclusion of women in the group, perhaps a different setting that was less sterile and had some military folklore and pictures around, the coverage of the war/peacekeeping theme on the first or second night, and finally one group member would have liked to have had spirituality included as a theme. -87-C H A P T E R F I V E - D I S C U S S I O N The purpose of this study was to document the subjective experience of veterans and peacekeepers in an intergenerational life review group. A qualitative methodology was used in working towards this end. The research questions asked were: 1) What are the specific competencies, skills and knowledge needed for successful re-entry into civilian life? 2) Can these skills, competencies, and knowledge be successfully passed on in an intergenerational life review program (LRP) involving both World War II veterans and peacekeepers? 3) Will the intergenerational passing on and receiving of these competencies, skills and knowledge lead to increased feelings of efficacy on the part of both World War II veterans and peacekeepers? 4) What changed for the individual during the course of the program and do they view their lives differently after the guided autobiography/life review experience? Some evidence of Birren and Deutchman's (1991) seven themes emerged from this research. In addition to this, 10 new themes emerged which represent the experiences of the five veteran and five peacekeeper participants. This chapter includes a comparison of these findings with the findings from the available research. It also includes a discussion of the implications of the results and recommendations for future -88-research and counselling practice. Discussion of the findings Comparison with the literature A comparison between the available research and the results of this study indicates that there are many similarities. Hansen, Owen and Madden (1992) used the word parallels to capture these similarities. Based on their findings they identified three parallels amongst soldiers: 1) The horror, abjection, and experience of contemporary warfare; 2) The most significant social institution in their experience, the Brotherhood, and; 3) The aftermath, which is in many ways more traumatic, and is certainly more prolonged than the period actually spent in combat (p. 10). These parallels were again reinforced by the 10 soldiers who participated in this study. Their words and actions provided an abundance of examples. The actual word "horror" was used over and over again by the participants — "the horror of going into a country where life means nothing"; "the horror in seeing the children" and so forth. The "clicking of the eyes" commented on by one peacekeeper reminded one of Heir's (1978) definition of abjection "... the responsibility associated with what you see that stays stored in your eyes." The comraderie or "brotherhood" also came up frequently as a theme and was actually the reason that one of the peacekeepers had decided to participate in the group in the first place. He missed the comraderie of fellow soldiers — the understanding seen in a look and the common language. The aftermath define by Hansen, Owen and Madden (1992) -89-was and is the accounts of estrangement, isolation, marginalization, exaggerated startle responses, searching for "the edge," drifting, unemployment, alienation, flashbacks, anger, broken families, substance abuse, nightmares, suicide attempts and prolonged introspection over having "gone over to the dark side" (p. 62). With the exceptions of exaggerated startle responses, suicide attempts and prolonged introspection all of these were talked about in the group. And that does not mean that exaggerated startle responses, suicide attempts, and prolonged introspection do not make up part of some of the group members experiences. It only means that they did not talk about them. As one veteran very simply and succinctly put it, referring to both the veteran and peacekeeper component of the group, "We both feel that we lost ourselves overseas and we are both healing." Fontana and Rosenbeck (1993) posited that the less severe Posttraumatic Stress Disorder (PTSD) symptomology reported among World War II veterans when compared with Korean and Vietnam veterans may be caused in part by the popularity of World War II. What they suggested was that being treated more as heroes at the time of homecoming may have mitigated the impact of war experiences on psychiatric symptoms of World War II veterans. Although not based on clinical observation a similar conclusion was drawn by one of the veteran members of this intergenerational life review group. In comparing the World War II veterans with the recently returned peacekeepers he stated, "Well to me it was an eye opener to the difficulties of peacekeepers... one of the things we had that -90-these guys don't have is public appreciation. Everybody was glad to see us but for these guys I don't think it can be quite so stimulating because they don't have the support; at least the visible support." Another valuable lesson that we learn from the research done on veterans is the importance of making treatment available upon a soldier's return from a combat zone. In a study done by Stretch (1991) on the psychological readjustment of Canadian Vietnam veterans, he found that Canadian veterans exhibited greater rates of PTSD compared with United States Vietnam veterans. Evidence of other psychosocial adjustment problems such as depression, inability to handle frustration and anger, difficulty in getting along with and trusting others, and family and mental problems, as well as poor physical health was also found. Stretch's (1991) research demonstrates that one of the contributing factors to these problems is the lack of readily available treatment for PTSD in Canada. This lack of immediate treatment and the feeling of being left to one's own devices was discussed by the peacekeepers in this group. When I asked one peacekeeper, "In your mind when do you think people should talk about it (referring to the traumatic events experienced in military service)?" he responded, "As soon as they come back. And even at the theater itself. It should be there. They should have counsellors down there right now... And have some trained professionals.... It should be dealt with and with trained professionals. And I don't mean a medic or a doctor." When compared further with the existing research this particular study was rather -91-silent on the impact that military operations has on family. Only one peacekeeper and one veteran made mention of it. The peacekeeper regretted his lack of time spent with his two sons while they were growing up and also felt that his Navy service was largely responsible for the break-up of his first marriage. Unfortunately, one could not tell from this study if the findings of Segal and Segal (1993), Bartone, Harris, Segal and Segal (1993), Gravino (1993) and Van Vrankenetal (1984) were to be further reinforced. The questions that would elucidate this evidence or lack of evidence were not asked. In retrospect, a few questions regarding family disruption caused by military operations could have been added to the family theme of Birren and Deutchman's (1991) model. This may have addressed the questions of impact on family. Overall though, this research broke new territory. Despite the recognition of late onset PTSD in aging war veterans and the acceptance and wide use of life review programs with the aging population in general, this researcher could only find one research study that combined the life review method with the aging veteran population. Molinari and Williams (1995) conducted a life review group with aging World War II POWs with PTSD. Molinari and Williams' (1995) conclusion was that participation in this PTSD therapy group had appeared to be uniformly beneficial for this small sample of World War II POWs, since it was geared to their unique wartime experience. They also attributed much of their group's success to the life review concept despite its slight variation from the traditional life review method. Their life review group differed in that - 9 2 -much of the discussion centered around a common central organizing event which impacted all other aspects of these veterans' lives — that being their POW experiences. One of Molinari and William's (1995) conclusions led quite naturally into this current study — that conclusion being that, "by revealing their survival strategies against the odds, POWs can also leave a legacy by chronicling the strength of the human will for the group leaders to pass on to future generations." This study looked at a cross section of World War II veterans and not POWs specifically. It also included the younger generation of peacekeepers right within the group itself as opposed to having the group leaders pass on the accounts of the strength of the human will. This study allowed the veterans to do this directly themselves. Another way in which this study broke new territory was its intergenerational component. The life review intervention has been used for a number of years with elderly populations. It is also starting to be used with middle-aged and younger populations. What has yet to be widely explored though, is the effectiveness of life review with intergenerational groups. Some family psychotherapy with intergenerational families has started but not necessarily with a life review format. In an unpublished study, Ashby (1997) interviewed participants of a brief intensive version of the guided autobiography/life review. The six participants ranged in age from 26 to 63. Participants reported appreciating the mixed gender group, and the ranges in ages. Comments indicated that this gave a depth and breadth to the interaction that would have been lacking otherwise. This particular study further backed up this appreciation of the ranges in ages in a life review group. Mixed gender will be commented on later in recommendations for future research. Examination of the outcomes One of the purposes of this study was to determine if the positive outcomes from guided autobiography described in the literature were reported by the participants. The findings demonstrated "strong" evidence of only two of the seven outcomes listed by Birren and Deutchman, 1991. I use the word "strong" here instead of "significant" as I feel that in the spirit of qualitative research and particularly life review that even if one participant reports an outcome it can be argued to be significant to that particular participant. In addition to the strong evidence for two of Birren and Deutchman's seven outcomes 10 additional outcomes were reported. Together all of these outcomes demonstrate the effectiveness of guided autobiography life review. Key points related to the outcomes and findings follow below: • Evidence was seen for life review facilitating the development of friendships amongst group members. These friendships developed quickly and rather easily. They seemed to be based on a soldier's trust of other soldiers and on a bond that comes from having lived through similar experiences. • Evidence was seen for life review facilitating the recognition of past -94-adaptive strategies to current needs and problems. Evidence was also seen for the intergenerational passing on of these strategies once they were recognized. • Only two group members reported the outcome reconciliation with the past and resolution of past resentments and negative feelings. As previously mentioned in the results chapter though, this researcher feels that more than just two group members experienced reconciliation and resolution. This assertion is based on what was witnessed in the group by the group leader, the researcher, and the participants — a lifting of depression, less hopelessness and helplessness, reduced anger and a slow building of trust towards others. I do not personally believe that any of this would have been possible without some reconciliation and resolution. I further feel that one weakness of this study was that a few questions directly pertaining to reconciliation and resolution were not asked at the final interview. • O f significance is the finding that not one of the participants saw themselves as more capable of "facing the nearing end of life with a feeling that they have contributed to the world." This concurs with the finding that Hunter (1997) had in a guided autobiography group that she conducted with members of the West Vancouver Kiwanis Club. It is significant because this is one of Birren and Deutchman's purported outcomes of -95-guided autobiography. As stated previously, this difference may be accounted for by the fact that much of Birren and Deutchman's work was done with elderly individuals. One could argue that these individuals are more likely to feel that they are "facing the nearing end of life" than young and middle-aged individuals. Interestingly though, even the elderly members of this intergenerational life review group did not seem to feel as if they were facing the nearing end of life. Also Hunter's group was made up of elderly individuals. • In addition to Birren and Deutchman's seven themes, evidence emerged for 10 new themes. Of particular significance were the normalization of one's reactions to trauma or to events, engendering of hope, relief or emotional release in telling one's story, relating/commonality with others and new awareness or heightened awareness of others' contributions and/or abilities. • All 10 of the group members reported the outcome "new awareness or heightened awareness of others' contributions and/or abilities." There is something significant in being able to step outside of oneself and recognize the worth and contributions of others. Particularly if what you are stepping out from is your own grief, pain and anger. • Nine group members reported the outcome "relief or emotional release in telling one's story." This was garnered from statements such as, "I came -96-back feeling lighter every week. It felt good"; "And when I read it out loud it felt like taking a part of it off of me actually "; and "The majority of them had problems that had seemingly been unsolved but after about three weeks discussion, or three meetings should I say, they were not entirely different but were certainly different from the way they had been when they first walked through the door." This ties in with this researcher's observation regarding reconciliation and resolution. Very often relief or emotional release is connected to reconciliation and/or resolution. • Normalization of one's reactions, engendering of hope and relating/commonality with others as outcomes were each reported by seven group members. Quantitatively this is significant but more importantly this researcher finds this to be qualitatively very significant. The emotion and conviction in the group members' statements lead to this conclusion — statements such as "... it was like a very profound normalizing effect for me. I came back feeling lighter every week. It felt good"; "Well I'm actually a lot calmer and I have more patience I feel a lot better about myself and.... um the depressions are not as frequent"; and "we both feel that we lost a lot of ourselves overseas and we are both healing." • Interestingly only six group members reported that the writing, reading and reflection method of guided autobiography was beneficial in enhancing -97-their group experience. Two group members did not do the written homework weekly. As the researcher and group co-facilitator it is my opinion that because of the size and magnitude of this group that we could not have successfully ran it without the guided autobiography format. The format most certainly gave the group structure. Also, I noted that the group member who did not do the written homework often needed facilitation to stay on track and on time. It would have been chaotic had this been the case with all ten group members. • A n unexpected benefit of the guided autobiography method was reported by the one group member who had had a cerebral hemorrhage. He reported appreciating the week in between group meetings to think about, and reflect on, the themes. He did not feel that he would have been able to spontaneously answer the theme questions in the group itself without prior preparation. This suggests that the written homework may serve a very practical purpose aside from just the therapeutic effect that the writing and reflecting may have. • It should be noted that the one group member who did the written homework on some weeks and not others reported that writing enhanced the sessions. His exact words were: "I like the writing... the discipline and planning of writing. It is definitely beneficial to enhance the meaning of -98-these sessions." Implications and recommendations for future research In this section, I wil l attempt to delineate suggestions for future research based on what is lacking in the current research. As demonstrated by this study and previous studies there is no shortage of possible research problems. Some potential research problems are as follows: • The technique of random sampling was not employed in this study and the sample size of 1 0 participants was small. Further research using random sampling and larger sample sizes would be useful in supporting the results of this study. As mentioned previously though, the actual group sizes themselves should be kept small, five to six members at most. • As past research and this current study support the existence of certain parallels amongst soldiers it would be interesting and beneficial to conduct further research using the life review method with mixed groups of soldiers. These mixed groups could consist of soldiers from different wars, different peacekeeping actions, various minority groups and the two genders. They could also include civilians who played a large part in wars and peacekeeping campaigns such as doctors, nurses, social workers, priests, Red Cross workers and so forth. • Having stated the above regarding mixed groups of soldiers it would also be -99-interesting and beneficial from a comparative stance to conduct life review groups with soldiers who have been through a specific or unique experience (i.e. POWs, War Amps, and so forth). Molinari and Williams (1995) concluded that participation in the PTSD therapy group that they had conducted had been uniformly beneficial as it had been geared to the POWs unique wartime experiences. • Taking the concept of mixed groups of soldiers one step further it would be interesting to conduct a life review group with veterans/soldiers from the different national and political sides of conflicts. • As it has been recognized that a soldier's combat and re-entry experience has an impact on their family it would also prove beneficial to conduct groups with the spouses and children of soldiers. • The finding that re-entry into civilian life has always been and continues to be a challenge for soldiers suggest the need for soldiers' groups that go beyond just a life review format. Additional components could include job skills retraining, life skills training and retraining, trauma repair, and so forth. • The finding that the veteran component of this life review group could pass on competencies, skills and knowledge for successful re-entry into civilian life to the peacekeeper component suggests the need for, and value of, other -100-types of intergenerational groups (i.e. intergenerational groups for sexual abuse survivors and so forth). • This particular study was not longitudinal and is therefore somewhat limited in its conclusions. Only a longitudinal study would indicate whether the benefits of life review and guided autobiography are lasting or not. It is important to note that because he moved out of the province one group member was not interviewed until approximately seven months after the group ended. Seven months later he reported lasting benefits from participating in the group. Again this concurs with Hunter's 1997 study. • There is an abundance of quantitative research on life review and guided autobiography yet these two programs lend themselves very naturally to qualitative research. More qualitative research is therefore needed which focuses on the participants' experiences as relayed by the participants themselves. • Because only two of Birren and Deutchman's (1991) nine themes were used it is not at all surprising that there was not strong evidence for their seven outcomes. It is possible that had all nine themes been used the results would have been different. Another study could look at the outcomes after a guided autobiography/life review group was completed using all of Birren and Deutchman's themes. This particular study was not conducive to this -101-as the war/peacekeeping experience and re-entry experience needed to be talked about. These are not two of Birren and Deutchman's nine themes. • As there arose questions in this study regarding the value of writing in the guided autobiography process further research in this area would be beneficial. Two groups could be set-up for comparative purposes; one group could write out the answers to the sensitizing questions, read their answers into the group, and receive group feedback whereas the other group could skip the writing component of this process. • Another weakness in this study was the missed opportunity to ask the group members what impact, if any, they thought this researcher/co-facilitator being female had on the dynamics and interactions of the group. All 10 group members and the group leader were male. Implications and recommendations for counselling In this section I will outline several implications for counselling based on this study. They are as follows: • A regret that I personally have is that I did not participate in a guided autobiography as a group member before co-leading this intergenerational group. This would have given me a deeper understanding of the participants' experiences. I recommend that all potential leaders of guided autobiography groups participate in such a group before leading one. -102-• I further regret that I did not have more knowledge of the history of World War II, conflicts that Canada has been involved in as peacekeepers, and the structure of the Canadian forces. This is such a specialized area, with so little research having been done on it, that at times I felt woefully inadequate in this regard. This despite 15 years working for V A C and being married to a former member of the Canadian forces. • Because guided autobiography is not designed to be counselling per se, it may attract certain participants who would never seek out, but may benefit, from counselling. Veterans and peacekeepers may be such individuals and although many of them would never attend a counselling or therapy group they would attend one with a story-telling or psychoeducational focus (Hunter, 1997). Then what sometimes happens for individuals is the guided autobiography experience ends up being therapeutic. For many of the group members in this intergenerational life review group this is what happened. • Within the guided autobiography process group members are given an opportunity to reflect upon and tell their own stories. Because of this guided autobiography may have particular appeal to counsellors who work with a client-centered or narrative approach (Hunter, 1997). There also exists within the process of guided autobiography the opportunity to engage -103-participants in positive reframing. • Group leaders should be trained in counselling skills. This is paramount and is one area in which I disagree with Birren and Deutchman (1991). This is also an area where Hunter (1997) disagrees with them. Birren and Deutchman (1991) state only that the leader needs to be a person who is "caring and interested" in helping older adults conduct their life review (p. 26). They stress that since guided autobiography is not therapy, nonprofessionals should "not probe into the feelings and emotions of group members beyond those that emerge naturally" (p. 26). In my opinion, this is potentially dangerous advice. One of Birren and Deutchman's themes centres around one's experience with death and dying. Suggesting that such a discussion may be facilitated by one whose only qualification is that they are "caring and interested" is inappropriate. Further, the very nature of some of the sensitizing questions are probing therefore asking nonprofessionals "not to probe into the feelings and emotions of group members beyond those that emerge naturally" (p. 26) is not realistic. • Group leaders should also be trained in leading groups before taking on a guided autobiography. Skills in listening, empathy, reframing, blocking, and so forth are essential. Group leaders also have to be skilled in assessing whether or not an individual is group ready or in need of individual counselling first. • This study and other research has identified the need for job skills training/career counselling for returning peacekeepers. It is important though, to realize that career counselling probably will not work in isolation. The other issues of PTSD, grief, anger, hopelessness, helplessness, guilt and so forth must be dealt with as well. • .Although guided autobiography is best lead by a skilled counsellor and leader it is not therapy. It is therefore important that the leader be knowledgeable of agencies and individuals to refer participants to should the need arise. It is also important that they are skilled in assessing this need. Impact of the life review group on the researcher The purpose of this study was to document the effect of an intergenerational group, involving both veterans and peacekeepers, on its participants. Earlier it was also asked what effect this researcher's gender may have had on the group. It is also important though, to document the effect the participants have on the researcher. This effect was transformative. It made me come face-to-face with and challenge one of my beliefs. In the beginning I was surprised at how fast and deep the group was moving on an emotional level. It surprised me because it was a group of men and I had a stereotypical attitude about men being closed off emotionally; particularly a group of "macho" men such as -105-soldiers. This attitude was most certainly challenged and, I am pleased to say, proved wrong by this group. Strange as it sounds, I also walked away from this group, whose focus of discussion was often trauma, with increased vigor and enthusiasm. I witnessed in this group of remarkable men countless examples of the resiliency of the human spirit. As a counsellor I felt hopeful — i f someone like Robert could go through what he had experienced during the war and come out the other end a productive, compassionate, happy man, husband, father, and grandfather then so could Jim given time and support. I only hope that this group may have been the start for Jim, the other group members and eventually other soldiers. B I B L I O G R A P H Y -106-Aarts, P.G.H., Op den Velck, W., Falger, P.R.J., Hovens, J.E., DeGruen, J.M.M. & Van Ruijin, M. (1996). Late onset of posttraumatic stress disorder in aging resistance veterans in the Netherlands. In P.E. Ruskin & J. A. Talbott (Eds.). 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Existential phenomenological alternatives and psychology. New York: Oxford University Press. Van Manen, M . (1994). Researching lived experience: Human science for an action sensitive pedagogy. London, Canada: Althouse. Van der Kolk, B.A., & Ducey, C. (1984). Clinical implications of the Rorschach in post-traumatic stress disorder. In B A . van der Kolk (Ed.). Post-traumatic stress disorder: Psychological and physiological sequenlae. (pp. 29-42). Washington, DC: APA Press. Vaughn, S., Schumm, J.S., Sinagub, J. (1996). Focus group interviews in education and psychology. Thousand Oaks, CA: Sage Publications, Inc. Westwood, M .J. (1998). Group life review program for Canadian veterans. Vancouver: University of British Columbia (unpublished). T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A -115-A P P E N D L X A Department of Counselling Psychology Faculty of Education 2125 Main Mall Vancouver, B.C. Canada V6T 1Z4 Tel: (604) 822-5259 Fax: (604) 822-2328 I N F O R M A T I O N S H E E T F O R T H E P R O J E C T " T H E L I F E R E V I E W P R O G R A M F O R C A N A D I A N W A R V E T E R A N S A N D F O R C A N A D I A N P E A C E K E E P E R S Dear Date: My name is Deanne Gervais and I am a Master's student in the Department of Counselling Psychology at the University of British Columbia. I am presently working on a thesis which is exploring the intergenerational benefits of the Life Review Program (LRP). Specifically, I am interested in "which coping skills arc similar and which coping skills arc different between World War II veterans and peacekeepers?"; "what are the specific competencies, skills and knowledge needed for successful re-entry into civilian life?"; "can these skills, competencies and knowledge be successfully passed on in an intergenerational LRP?"; and "will the intergenerational passing on and receiving of these competencies, skills and knowledge lead to increased feelings of efficacy on the part of both World War U veterans and peacekeepers?" This topic is of great interest and meaning to me, and is a largely unexplored area of research. I was given your name by ; who thought that you might bo interested in participating in this program. The program is based on a lifespan perspective of development and will utilize a combination of guided autobiography and interviewing of older veterans by younger peacekeepers. This will all be done within a small group setting. The group will mccl once a week for three hours for six weeks. Following the group's completion each participant will be interviewed individually. TV interview will be approximately one hour in length and will be audio-taped. All of the information will remain confidential and will be accessible only to myself, my supervisor and two other members of my thesis committee. Names and other identifying information will not be included in the final thesis. Audiotapes will be erased at the completion of the thesis. Your participation in this study/program is entirely voluntary. You have the right to refuse to answer any questions and/or withdraw from the study al any lime without any negative consequences to you. 1 of 2 -118-Each group member will agree to maintain strict confidentiality. Only the researcher, research supervisor and two other thesis committee members will have access to the audiotapes and interview summaries. Confidentiality will be further guaranteed by the use of code names and all audio-tapes will be destroyed within a set period of time after the conclusion of the research project. If you decide to participate in the study you may refuse to participate or withdraw at any time without prejudice. In order to participate in this study you must be either a war veteran or a peacekeeper, be willing to attend group sessions regularly, maintain confidentiality and participate in activities and discussions. If you would like to participate in this study please complete the following section: If I have any questions or desire further information with respect to this study, I may contact the researcher and research supervisor at the above telephone numbers. If I have any concerns about my treatment or rights as a research subject I may contact the Director of Research Service at the University, Dr. Richard Spratley at 822-8598. I understand that my participation in this study is entirely voluntary and that I may refuse to participate or withdraw from the study at any time without jeopardy to my standing as a member of any veterans' or peacekeepers' organization. Also if I am in receipt of benefits, or have applied for benefits, through Veterans Affairs Canada a refusal to participate or a withdrawal from this study would not jeopardize my standing with this organization. I have received a copy of this consent form for my own records. I5 . , consent to participate in this study. Subject Signature Date Signature of Witness Date -120-A P P E N D I X D Interview Schedule 1. Introduction 1.1 Establish rapport: • i.e. "It is nice to see you. I have missed you and everyone else from the group." Talk for a few minutes, get comfortably settled, etc. 1.2 Establish purpose of the interview: • "First, I would like to thank you for your time and your willingness to be interviewed. I realize and appreciate that you have already given a lot of your time in coming to the six sessions. This interview is a really integral part of the research because we are wanting to learn what veterans and peacekeepers think of intergenerational life review groups. Do they feel that they are helpful or effective? And as I brought up before, in the course of the sessions, this is a relatively new type of group, so your comments are going to be very valuable. The interview is going to last approximately one hour — it might be more, it might be less I have several questions that I have written out ahead of time and would like to tape record your responses. This is to ensure accuracy in reporting. Taping will enable me to transcribe word-for-word what you have said." 1.3 Go over consent form and ensure confidentiality. • "To start I would like to go over this consent form, that you filled out when we first started the group, with you. This form outlines the intended purpose of this interview. The interview will be tape recorded and later transcribed. Only myself and the thesis committee (Dr. Marvin Westwood, Dr. Norm Amundson and Dr. David Pedlar) will be able to read or listen to the tapes or transcripts. Any information that would identify you will be altered. I will not be using your real name in the thesis. You can choose what is known as a "nom de plume" or i f you prefer I can choose the name for you. You will be referred to as this name throughout the thesis. I also want to stress to you that after my thesis is completed the tapes will be erased. Similar to the group we were in where you could decline to participate at any time, you can decline to participate at any time or request that the interview be stopped. Do you have any questions regarding the consent form and/or tape recording? Answer any questions. 2. Standardized open-ended question: -121-I would like to start the actual questions now i f that is alright with you. 2.1 To begin, I would like to hear about your experience in the intergenerational Life Review group. 3. Semi-structured questions: 3.1 Do you view your life any differently since participating in the group? What are you aware of that is different in your life as a result of being in the group? 3.2 In the group there were three parts/aspects to the reflection experience. First, members wrote on the theme, then they read out loud what they had written and then other members gave them feedback. Do you remember each of these three parts/aspects? What do you think of this way of reflecting? 3.3 What effect or impact, i f any, did the group members have on you? 3.4 Some people found it emotionally difficult to look back on their wartime/peacekeeping and re-entry experiences. I am wondering i f this happened to you, either during or after the group? 3.5 To be asked of the veterans: I am wondering i f you feel that you were able to pass on any information or coping strategies to the younger peacekeepers who participated in the group? If so, what are your thoughts and feelings on this? To be asked of the peacekeepers: I am wondering i f you feel that you received any information or ideas for coping from the older war veterans who participated in this group? If so, what are your thoughts and feelings on this? 3.6 I am wondering i f there were any similarities between your experience and the experience of the veterans/peacekeepers that you were not aware of before participating in this group? Any differences? If so what were they? Do you find knowing this helpful to you? 3.7 I may lead similar groups in the future. I'm wondering i f you have any ideas or suggestions about how to make a group like this more effective? 3.8 I would also like to know i f you would recommend a Life Review group to other veterans or peacekeepers? If so, why? -122-3.9 Is there any comments or thoughts that you would like me to take back to Veterans Affairs Canada with me? 4. Demographic Data: 4.1 I would like to check a few facts with you. I need to be able to describe you accurately when I write my thesis. 4.2 (Age): Would you be willing to tell me your age? 4.3 (Service): I remember that you were in the branch of the services. Would you mind telling me your years of service and what theatre(s) of war or special duty areas(s) you served in? 4.4 (Education): How far did you go in school? Have you taken any further course work, training, etc.? 4.5 (Work): If you are still working, I am wondering what work you are involved in? If you are retired I am wondering what work you were involved in? I am wondering what social groups you may belong to? Volunteer work? Hobbies? Community involvement? 5. Conclusion: 5.1 I would really like to thank you for your time and for the comments that you have shared with me today. I really appreciate the contribution that you have made to my research. I thank you for that. Before we turn the tape recorder off I wonder if there is anything I have not asked that you would like to share with me. Adapted from: Hunter, C. (1997). Guided autobiography for older adults. Vancouver, BC: University of British Columbia (Masters' Thesis). - 1 2 3 -APPENDIX E SUMMARY OF FINDINGS Benefits of Life Review (Birren and Deutchman, 1991) • Sense of increased personal power and importance. • Recognition of past adaptive strategies and application to current needs and problems. • Reconciliation with the past and resolution of past resentments and negative feelings. • Resurgence of interest in past activities or hobbies. • Development of friendships with other group members. • Greater sense of meaning in life. • Ability to face the nearing end of life with a feeling that one has contributed to the world. ** Evidence of outcome documented in "Guided Autobiography For Older Adults.'''' New Outcomes "The Life Review Program For Canadian War Veterans and For Canadian Peacekeepers" • Normalization of one's reactions to trauma or to events (e.g. re-entry). • The receipt of specific advice, ideas, or assistance. • Engendering of hope. • Relief or emotional release in telling one's story. • Feeling heard/Being listened to. • Relating/Commonality with others. • New awareness or heightened awareness of one's contributions and/or abilities. © New awareness or heightened awareness of other's contributions and/or abilities. • Positive feelings obtained from others' responses to one's story. • A new appreciation of one's life through comparison with other group members' lives. Theme Assignment: Your Re-Entry Experience -124-APPENDEX F When we serve our country, whether it be in a war or on peacekeeping duty, inevitably part of our experience will be re-entry into civilian life. This event can be both joyful and sad at the same time. In fact, it is an event that can leave us with many mixed emotions. For many, the re-entry experience has been a major branching point. For some, it is even a life changing event. How has your re-entry experience impacted you? Think about your re-entry experience by reflecting on the following questions. Remember, these questions are given as a guide only. You don't have to answer all of them! As thoughts come to your mind, write them down or make a few notes. 1. Returning to civilian life often means challenges, rewards and difficulties. What was it like for you? 2. What changed when you came home? 3. What was the best thing about returning home? 4. What was the worst thing about returning home? 5. Often people have to make important decisions when they return home. What about you? 6. When you returned home did you feel that others understood you and the experience that you had been through? Did they respect you and treat you with respect? Did they try to avoid talking about the war/peacekeeping experience? Did you? 7. If you could go back to the time that you returned and give yourself something that was required or provide yourself with a necessary service, what would that look like? Describe what that would be? Theme Assignment: Y o u r F a m i l y -125-What is your family? This history of your family includes your family of origin (among them, grandparents, parents, siblings, uncles and aunts) as well as your family of adulthood (among them, spouse, children, grandchildren). One may also find a feeling of "Family" in organizations/institutions, ie., in the military, in university sororities, etc. The family members important in shaping your life should be mentioned, not necessarily all the family members. Some have been more important in positive ways and some in negative ways in shaping your life. What family members have had a major impact in shaping your life? Why? What would another person have to know about your family in order to understand you and how you've come to be the person you are'7 Sensitizing Questions 1 . Who held the power in your family'7 Why 0 Who made the decisions'7 How-did you know? 2. Who offered support, warmth, and nurturance? Why? Who did you go to for comfort? Who did you confide in? 3. What major family member(s) have you been closest to? Why? 4. What important family member did you know the least? Feel least close to 7 Why? Who should you have been close to but for some reason were not? 5. What was best about your family? Worst about it? What were (are) the strengths and weaknesses in your family? 6. Who were the heroes in your family9 The family favorites? How did you know? 7. What were the major areas of conflict, problems, and issues in your family? 8. What were the rules in your family, the "shoulds" and "oughts"? 9. What events and experiences have torn your family apart or have made your family stronger? 10. When was your family the most there for you? 11. Has your family ever let you down or betrayed you? 12. Did you have a difficult or easy time integrating back into your family when you returned home from war/peacekeeping? Adapted from: Birren, J., Deutchman, D. (1991). Guiding Autobiography Groups for Older Adults. Exploring the Fabric of Life. Baltimore, London: John Hopkins University Press. THEME ASSIGNMENT: YQTJR MAJOR LIFE WORK OR CAREER What is a career? It is your major life work. It occupies your energy, your work outside the home for pay. A life work can also be found in being a husband, a wife, a parent, or in religious devotion, in play, in art, in education, in community service. This does not necessarily involve a salary or pay. People can have a number of careers, a sequence of careers, or both. What has been your major life's work or career? Sensitizing Questions 1. How did you get into your major life work? When did you begin your life work? 2. What has been the developmental course of your life work? Has it been continuous? Discontinuous? What have been the peaks and valleys? Have there been major or minor setbacks? Major changes in focus? Have you had a sequence or series of careers? 3. What have been the biggest influences in directing the path of your career once chosen? For example, have they been people, places, events? 4. If you do not have a major life work (yet), what would you like to do? Why? 5. If you feel you have finished your major life work, how do you evaluate it? 6. Are you "on time" in your career, or ahead or behind in terms of your expectations? What have been (are) the challenges of your life work? Your successes? The problems? The failures? 8. If you have more than one life-work identity, which of these has been the most important to you? Why? 9. What has been unique or special about your work experience? Place of work? Travel? People? 10. What have you enjoyed the most about your life work? Least? 11. If you had it to do over again, how would you develop differently along " your life-work path? Would you choose the same life work? Why or why not? N 12. Did you have a difficult or easy time moving from military work into civilian work? Adapted from: Birren J., Deutchman, D. (1991). Guiding Autobiography Groups for Older Adults. Exploring the Fabric of Life. Baltimore, London: John Hopkins University Press. 7 -127-Theme Assignment: Your War/Peacekeeping Experience In the military we are asked to do things or are witness to events which we would not normally experience in civilian life. This shapes our lives in several ways. Enlisting, serving and returning to civilian life can include experiences of adventure, failure, accomplishment, and loss. Al l of us who served in a war or a peacekeeping action have encountered things that we would not normally have experienced. They may be called unnatural events or abnormal occurrences, or some things we just shouldn't have to witness or experience. Each of us will react differently to these events and some of us will react in similar ways to others who have been there. Consider the following questions as you write about your experience of these types of events. . Remember, these questions are given as a guide only. You don't have to answer all of them! As thoughts come to your mind, write them down or make a few notes. . 1. Think about the moment you decided to enlist. What prompted your decision? How did your family and friends react? 2. What important lessons did you learn as a result of your war/peacekeeping experience? 3'. Thinking back to your wartime/peacekeeping experience, what was one event that you experienced, witnessed, or participated in that has stayed with you to this day? 4. As you recall the event now, what are some of the main reactions, experiences, feelings, memories, etc., that come up for you? 5. If applicable, what do you wish you had done differently? What do you wish you had been able to do in that event? Would you do the same thing? 6. Again, if applicable, what regrets might you have about the situation? 7. How has this event shaped the person you are today? How has it impacted your life since then? Adapted from: Brown-Shaw, M , Hunter, C , Peck, E., & Westwood, M . (1998). Black, T. & Westwood, M . (1988). 

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