Talking is Easy for Therapists, Except When It's About Guns. Veterans Want to Teach Them How.

Jay Zimmerman got his first BB gun when he was seven, and his first shotgun when he was ten.

“Growing up in Appalachia, you look forward to getting your first firearm probably more so than your first car,” he says.

His grandfather taught him to hunt squirrel and quail. Zimmerman, who lives in Tennessee, says pretty much everyone he knows has a gun. It’s just part of the culture.

“When I went into the military, that culture was reinforced,” he says. “Your weapon is almost another appendage. It’s part of who you are.”

Zimmerman was a medic in the army in the late 1990s and early 2000s. He served in Bosnia, Africa, and the Middle East. Since he came home, he’s struggled with PTSD and depression. It reached a crisis point a few years ago, when his best friend -- the guy who had saved his life in a combat zone -- killed himself. Zimmerman decided his time was up too.

“I decided that I would have one more birthday with my daughter, one more Christmas with my daughter,” he says. “I had devised my own exit strategy for sixteen February, 2013.”

But then he bumped into a woman who used to ride the same school bus when they were kids. His exit date came and went. They’re married now.

Zimmerman is a peer counselor at the Mountain Home VA Medical Center in Johnson City, Tennessee. He also travels to conferences all over the country, sharing his story with therapists and with other vets. He tries to set an example that it’s okay to ask for help. Even today, if he’s not doing well, he disassembles his guns and stores them separately from ammunition, so he can’t make any rash decisions. If things get really bad, Zimmerman has a special arrangement with a few friends.

“I call them and say, 'Look, I’m feeling like it’s not safe for me to have firearms in my home. Can you store them for me for a couple days till I feel like I’m OK to have them back?'"

Suicide is an impulsive act. Nearly half the people who survive an attempt say the time between their first thought of suicide and the attempt itself was less than 10 minutes. But the method can mean the difference between life and death: people who take pills have time to change their minds. Not with guns.

About 70 percent of veterans who commit suicide do so with a gun, which prompted President Barack Obama to order the VA to talk to vets about gun safety and storage options like the ones Zimmerman uses.

But here’s the trouble: Most therapists aren’t gun people. They don’t know how to talk about guns. And so they don’t.

“One obvious reason for that is that no one has taught them how,” explained Megan McCarthy, National Deputy Director in the Office for Suicide Prevention at the Department of Veterans Affairs.

McCarthy was invited to speak recently at a suicide-prevention conference in San Francisco for therapists who work with vets.

“How many of you would say you feel really comfortable having a conversation with any of the people you work with about limiting access to all lethal means?” she asked the roomful of therapists.

Hardly anyone raised their hand.

“Okay, so that’s why we’re here today,” she said.

Researchers recommend starting with a field trip to a shooting range. There, therapists can learn about different kinds of firearms, as well as gun locks, and get an introduction to gun culture.

When counseling vets, therapists have to ask more questions and be less directive, according to McCarthy.

“We often conceive of ourselves as experts, as people who impart information to clients,” she said. But with vets, "it may take time to build trust. Telling them what to do the first time you’ve met them is probably not going to be a very effective approach.”

 

McCarthy presented a case study at the conference: A 28-year old army veteran who fought in Iraq told his VA psychiatrist that he had an argument with his girlfriend last week. He drove to an empty parking lot and sat with his loaded handgun in his lap, intending to kill himself.

He didn’t do it. A week later, the man told his psychiatrist things were still tense with his girlfriend. But he didn’t want to talk about suicide or storing his gun.

McCarthy asked the clinicians in the audience what they would do next, if they were this man’s psychiatrist.

“Why did he not do it? That would be my question,” said one therapist.

“I’d say, would you be willing to talk more about that?” said another.

“I would want to see this individual again, within the same week,” said a third. “I believe in strong intervention.”

Jay Zimmerman, the former army medic and peer counselor, stood up. He told them they’re all wrong.

“Chances are the reason he’s not talking to you is because he’s afraid he’s going to lose his gun, that he carries pretty much all the time,” he said. “My buddies are the same way, we all carry all the time.”

Zimmerman said the vet in the case study would rather talk to someone like him than someone in a white coat.

“If he’s got that good relationship with me as a peer, as a buddy, he’s probably already called me and talked to me,” he explained.

The takeaway for psychologists at the San Francisco conference, McCarthy said, is that sometimes their role is not to intervene, but to be a facilitator, someone who can connect vets with peer counselors like Zimmerman, or suggest they talk with a buddy, not always a professional.