Interview with Dr. Heidi Cramm

In this month’s episode we speak with Dr. Heidi Cramm about the research that she - and her team at the Families Matter Research Group - are doing about the impact of Military life on the family.

Trigger warning:  In this discussion we do talk about suicide and suicide ideation as it pertains to CAF Members and their families.  This discussion begins at the 20:00 mark.  Please listen with caution.

In our discussion we talk about:

·       How the definition of family is changing;

·       What it means to be resilient;

·       What research is being done regarding Military families in Canada and in other countries;

·       How no one really knows ‘what they signed up for’; and

·       How the challenges facing families change throughout our lives and careers.

About our guest:

Heidi Cramm is an occupational therapist and associate professor at Queen's University. Since her time working in children's mental health in a military community, she's been committed to conducting military families health research for the past 10 years and is the Research Advisor at the Canadian Institute for Military & Veteran Health Research (CIMVHR). In 2021, she consolidated her research under the banner of the Families Matter Research Group (FMRG). Through the FMRG based at Queen’s University, she leads a variety of health and well-being applied and collaborative research designed to improve the lives of military, veterans, public safety personnel and their families. Dr. Cramm and her teams explore how the occupational risks and requirements of military and public safety service shape the roles, routines, and rhythms of family life, with a keen eye to how mental health and impacts of trauma can affect families and how, in turn, families can affect the serving personnel.

Do you want to learn more about the research we discussed in this episode?  Check out the following links:

·       Families Matter Research Group - www.fmrg.ca

·       Canadian Institute of Military and Veteran Health Reasearch:  https://cimvhr.ca/

Learn more about Dr. Cramm and follow her social media:

·       https://rehab.queensu.ca/heidi-cramm

·       Facebook: @familiesrsch 

·       Twitter: @families_rsch and @HeidiCramm 

·       Email:  families@queensu.ca; 

·      https://cimvhr.ca/our-team/heidi-cramm/

Transcript

Episode 4 – Interview Transcript

Trigger Warning:  This month’s episode includes a discussion about suicide and suicide ideation.  Please listen with caution.

[02:28]

Julie Hollinger:

HI Heidi – It is great to have you here on Military Family Life.  Can you please introduce yourself, tell us what is so what it is that you do, and maybe your connection with the military? 

Heidi Cramm:

So I'm Heidi Cramm and I was trained as an occupational therapist. Now a lot of people haven’t had an opportunity to kind of interact with occupational therapists. But really what we're focused on is when people have difficulty doing the things they need to do. want to do or are expected to do. And when kids are struggling with mental health, then they often have a lot of difficulties with, you know, meeting academic expectations to you know, be doing well at school, if they have a learning disability, if they have anxiety -maybe they have difficulty making friends regulating their behavior - all those kinds of things can happen when kids have any combination of learning disability, autism spectrum disorder, ADHD, those kinds of things. 

So, I was working in child psychiatry here in Kingston, which is a military town. And you know, we see all these military families I always had questions like, why are we seeing military families?  like doesn't the MFRC see military families?  I had no idea all about the health systems at all you know, what is and isn't there for military families. So that kind of put me on a path of having a lot of questions that I didn't have a lot of answers to.  Because when I started going to look for how do I understand why I'm seeing so many military families? I couldn't really find the answers I was looking for. 

And so, a number of years later, having worked with a lot of different military families, because when you work with children's mental health, you're working with family mental health. When kids are struggling with their mental health, it has an impact on their families and their siblings and everybody's kind of in that mix. So we did a lot of parenting challenging children classes, all kinds of things like that. So, years later, we're back to do my research training. And when I completed my PhD, I was fortunate enough to get a job at Queen's and, as luck would have it, the Canadian Institute for Military and Veteran Health Research (CIMVHR) was based right in my department.  So we typically call the Canadian Institute for Military and Veteran Health Research CIMVHR for short, and Dr. Alice Aiken was a physiotherapist in a school of rehabilitation there and was like: you know, you've done all this work on mental health, on kids, why not focus on military families? Somebody really kind of needs to take this up and figure out what's going on for military families, what do they need, and that was 10 years ago. 

So I've been working on that in a variety different ways as a researcher, yeah, for the past 10 years trying to, to help understand what's going on for military families, veteran families, you know what mental health looks like for them, what accessing mental health services might look like for them, but hopefully that gives you a sense of where it all started. 

[05:13]

JH
So a lot of your research is around mental health. It's around families. Does having a family positively or negatively affect military members as they go through their career and as they deal with some of the trauma and the experiences that they're dealing with on a deployment? 

[05:25]

HC:

Well, you know, a family can provide a really strong foundation and a set of social support for for people who work in jobs where there's a lot of occupational risk. There's a lot of requirements outside their control. And you know, Canadians are brought in looking to members of our Canadian Armed Forces to ensure our security here and abroad. And so you know, when families are in that with them, they're serving alongside and they're doing their part and that, that does mean that there are additional things that military families have to consider. Those things can be hard on military families. Those things can help military families thrive. 

So you know, there's no blanket statement that says what military families are. So you know, when we look at some of the common things that we see is military families are resilient, and I would say sure, but aren't we all resilient until we're not? And so when you create this kind of expectation of resiliency, I get a little bit apprehensive about maybe we're putting an expectation on people to be resilient and not look for help when they actually need it. And that's always a concern that I have as a mental health clinician. Because everyone depending upon the resources and you got enough stuff coming at you at any given moment, everybody is going to need help at different points in their family life cycle, in the personal life cycle. There's no straight answer. 

JH:

I know that personally, I don't like the word resilient. I think that when people say military families are resilient to me, it almost sounds like you should be fine. You know, pull up your socks. Are people more hesitant to use that word resilient? 

[07:00]

HC

I think there's been a lot of discussion about what is resilience, what is resiliency? And I find that there's a risk that we can almost weaponize the concept like: well, I gave you resiliency training. So therefore, if you're not doing well, that's kind of on you. 

And so that's a concern that I have in the broader context, not in relation to military families. I do find that it's this kind of odd dynamic that we see this messaging is that military families like are in dire need, AND military families are resilient.  Well, yes. And maybe they're both, you know, at different times. And so, I think that's normal in any population of people to you're going to have people who are doing really well. You're going to have people who are struggling at any given time. I think being able to understand under what conditions do military families do really well. How do we foster those conditions? And those conditions should be a shared responsibility that we all are doing our part to make sure that those conditions are in place for military families. 

[08:00]

Claudia Beswick:

I think whether it's negative or positive it’s the unknown. Not everybody understands - even someone new to the military -w hat some of those challenges are, and I think information really is key. And if they don't understand, or they don't know, then to reach out and ask those questions. Not everything has to have that mental health tag to it. It could just be information. What does it mean? What does it mean to be deployed? To someone that doesn't have that background, they may not understand everything that that entails for the family.

HC:

Well, Claudia, I couldn't agree more. You know, because of the work that we've done with military and veteran families we've had a lot of questions about public safety families and I'm a member of public safety family. My husband's a firefighter, and I've seen a lot of the parallels. 

And when we look at that literature, as well, and we come back to military and veteran families, you know, there's this issue of there are just certain things within family structures that are shaped by attachment to these groups. So, we're kind of framing it as what are the risks that just go along with the job? What does it mean to be on the job? It means that you're going to be deployed.  Okay, well, what does that mean for me in my family, and what does it mean for me and my family at a different point in my life cycle, because it means something different for me if I'm dating someone who's deployed, versus I've got posted to some remote region of Canada away from my extended support system, and I have three small kids. Those are two very different experiences. 

So I think that being able to know what you're signing up for is one of those things that we're seeing across sectors as well where, if you come from a military family, and you moved around, you have a sense that this is what life kind of looks like these patterns, these are the routines. Well, you know, you got a sense of it, but you may not have a true sense of it beyond the life cycle phase that you're in. 

So for now, I have a sense of it, but once I have kids, well, that is different. And how many of our serving members are married to other serving members? Well, now you've got a big potentiator, right like now, it's compounding all those extra challenges

CB

Or if you're a parent who has their son or daughter in the military, clear across the country, not understanding: anything about a military lifestyle, not near an MFRC, or base or anything. That's a whole different set of challenges as well. 

[10:25]

JH

One of the things that people sort of fight against that whole idea of is: well, you knew what you signed up for, but you're talking about the different circumstances. You know, I might be resilient if everything goes perfectly on deployment, but it's not.  Like we're in the middle of a global pandemic, you probably would have been fine otherwise, but you could never have prepared for that. You could never have prepared for so many of the other things that come along with it. So you know, talking to spouses about you should have known this you can prepared for it. There's some things you can never prepare for. And when you are young and getting married at the age of 22, you don't know what life's gonna be like later. 

HC

Yeah, this this I think it's a real false kind of concept that you could know what you signed up for. I mean, maybe if I signed up for you know, a guided trip somewhere I had a sense of what I signed up for because somebody there with me, and they are going to take me through every step of it. But you know, if I if I go to some place I've never been then I don't really know what to expect if it's a completely new location. It's just doesn’t play out like that. And I think in life, it doesn't play out like that. You knew what you signed up for? 

CB

And I mean, what I signed up for when I was 20, or 22. And how I took my view on the military lifestyle is very different now that I'm 50 plus

[11:35]

HC

Claudia, I want to come back to when you raised parents.  And I think this is a really important thing that speaks to when people sign up and where they are in their own life cycle because they may be coming from the family home where their parents are their family.  And we've done a lot of work with the Vanier Institute of the Family, with other family researchers internationally as well to really try to understand what does military families mean, you know, it's not just a spouse or partner. It's not just small kids. It could be like your grown-up brother who's trying to support you, it could mean your mom or your dad or your grandparent, your aunte your uncle,  And you know are the programs responsive and inclusive to people who are coming in as the support system of the individual?  You know, people who really care about the well being of that individual who has dedicated themselves to the Canadian Armed Forces.

[12:28]

 CB

And that's why one of the biggest things that I would say we've come a long way on is the definition of what family is. Family isn't just about the spouse or partner - or even the parent.  That family to that CAF Member is someone who is significantly important to that CAF Member. And I think that really broadens the perspective of the types of supports that are available and who can reach out to them. 

JH:
You talk about getting information and researching families. How do you hear from families, what does what does your program do? How do you get that information about families and what's the most kind of useful information that you get? 

[13:05]

HC:

Currently, I have many hats that allow me the opportunity to kind of engage with families, and hear from families, and communicate with families. 

So I'm the Research Advisor for CIMVHR, and in that role I've been beginning to do especially now kind of on the other side of the pandemic where people are more familiar with technology, more comfortable technology, we're building a strategy on how we can engage with MFRCs. If we can engage and reach you know, folks who are impacted by and would want to know about -and participate in-  the creation of the research and what questions we're even asking. 

So there are different kinds of researchers and the folks in my group are the academic folks who are kind of outside of government. And so, when we look at how we find families, a lot of it is through word of mouth, through social media and kind of trying to invite families to participate in research and to share, you know, our findings with them and to get that out, you know, using things like Canadian Military Family magazine to describe some of the things that we're looking at. 

There are things that military families probably don't know a lot about because they haven't had the opportunity to find out about them. But CIMVHR has a journal that's open access, which means anybody can get it- there's no paywall. And so there's a whole bunch of research that comes out about families. Some of it's in format like an infographic rather than an academic journal. So there's different ways of getting at that.

But we also just launched within my research group, the Families Matter Research Group, and this is where we're kind of consolidating all of the work we're doing in creating the research across the military veteran and public safety family sectors. And so that's an opportunity, though, to be building on how to get people familiar with the work that we're doing. Find out more about what we're finding and create some pathways for communication about you know, how research can be used.

JH:

We're gonna put all the information about the Families Matter Research Group, and CIMVR in the show notes. So, if people want to go in and take a look at that research. And I like that you said it's in some in an accessible format, because I think oftentimes, people think: I'm going to go read a research study like am I going to understand it? Is it going to be relevant? How does it make a difference to me? So we will put all those links in there.

[15:15]

HC:

Yeah, well, and also, you know, one of the requirements that we've been trying to introduce through with CIMVHR in either the journal or in the annual conference that that we run, is the concept of a lay summary. So to take that kind of technical jargony language out and give people kind of the highlights in lay language just you know, anybody could be able to read it and get a sense of what it's about - and to make it so that people can keep current. 

One of the things that we do know is that it's not clear where people go to for their information, right? Are they looking to you know MFS? You know, if they're MFRCs. Some MFRCs have to come to CIMVHR when we had kind of the in person at last year. The last two years have been virtual, so there's an opportunity for I think, different people to participate that maybe have historically. But it's a great opportunity for people to hear about the research and to be with other people across sectors who are trying to figure out well, okay, here's the new research, you know, what does this mean for me in my practice? What does this mean for me in my MFRC? What does this mean for program development? What are the next steps on this? 

None of this is like straightforward. There's no simple answer to anything. There's all little pieces that we work on, but it is one of those things that collectively we make movement that is kind of forward motion. It does take time though

[16:35]

CB:

And Heidi, I have been to quite a few of CIMVHR conferences in person. The value that I found listening to the summaries of the research that has been going on, I brought that back to our MFRC as a starting point, because often it's hard for families to voice what their struggles are, right? Or where do we start? Where does an MFRC start in providing some services? Or how do we know how to pinpoint something? 

So, if we know that through one of the surveys that young children are struggling with depression or stress management because of ongoing deployments or you know, if they've had back to back deployments, that's very hard for young children. And so some of the results of the surveys gave us a baseline of how do we start to ask the questions to the families.  And I found that very helpful, because it's hard sometimes for us to say to families, let's have a community conversation or a forum and tell us what it is you'd like to see. Because oftentimes they don't know - or they don't know how to put a voice to what their families are going through. So you know, the CIMVHR conferences for me was very beneficial on that front to be able to bring that information back to our center. 

[18:00]

JH:

Are there similarities between the Canadian experience and the American experience when you look at Military families, overall, there's similarities and Canadian experience versus across the board? Is the military more alike or is it a Canadian / American experience? 

HC

So I think if you want to think about the scale of the American Military relative to the Canadian population.  There are more pediatricians in the US Military than there are in Canada. 

JH:

Huh…

CB:

That's a lot.

HC:

That's a lot. So, I mean, the military in scale is just so big. Now, I use that as a point of reference as well because we don't have pediatricians in the Canadian Armed Forces, because unlike the US, health services aren’t provided by the military. In the US, they are provided directly to the family members. 

So there's all kinds of data that you can look like look at in the US where you can see, oh, this service member’s history, tick, tick, tick.  Like you can watch it and timeline and what the family members were doing in terms of their health utilization, like what services they needed. 

We can't do that in Canada. We don't have a way to match the service history data with the publicly funded health use data. We don't know how to do that. Like there isn't a mechanism to do that. 

And then there's the matter of the health systems are very different. So in our research group, and in the work that we do, we do like to look at some of these comparisons because comparisons are important. It's not a big community, the Family Researcher community. So we want to make sure that we get the kind of biggest bang out of our buck and make sure that we can, you know, learn from each other wherever we can. 

[19:44]

I've got a colleague at King's College London, in the UK, Professor Nicola Fear.  Like if you've been to CIMVHR’s reform you may have seen her speak – she’s often a speaker on research there. And the way the National Health Service works over there is pretty similar in a lot of ways to you know what we have.

We have more comparability with kind of the colonies and the way the healthcare system works, and how deployments and participation in different conflicts have looked, then maybe we have with the US.  But the US has had so much research on families, we have to be careful in how we use it and that we don't over apply it because some of the differences are in the health system itself. 

We do an international roundtable on Military Veteran Families every year with Kings and they were part of the group that we developed the policy documents on what it means like how are military families defined, and we looked at that across those five countries. We also like to do international work to make sure that we can find things in similar countries. So we just finished up with my research group. We had done a project on suicide prevention and where military veteran families are included in suicide prevention, research and policy. And again, we looked at the Five Eyes countries. And then we also looked at Israel - because Israel does a lot with where everyone serves in Israel, and Denmark is a comparator as well just to see if there's other things happening kind of in the in the European Union.  Because we're looking for kind of examples of best practice we want to be able to see like are there things out there that are evidence based that we can use. So that comparison is an important part of the work we do.

JH:

So what did you find out?

[21:30]

HC: 

So that was funded by the Center of Excellence for PTSD based at the Royal in Ottawa. And it has been an interesting process, and it allowed us to see is that certainly in the research. 

First of all, I mean, there hasn't been a lot of programming that has included families and this came out of again, this kind of question of gosh, like who's more affected than families by suicide, right? We see all of these kind of military initiatives on suicide prevention, but as the family researchers like:  but where are the families. I feel like we want to see where the families are. 

And so the study was really kind of getting the foundation for what is there what is knowable in the research, what is there in the policy, you know, where are we going with this? What is the best practice around families?

What we found was that families are often considered to be a variable. So they're just kind of like a factor like. And it can it can cut one way or the other family can be a social support or families can be a source of volatility. So you can have anywhere on that chain. And so we also see that there's a lot about how families are kind of expected to act as intervenors. And so there's this assumption or this extension of assumption that families are somehow you know, ‘responsible-alized’, there's an expectation that families are going to step into this role - whether or not they want it - on how to recognize and respond to people experiencing kind of suicidality, suicidal thoughts and behaviors. 

Even though there's that expectation there isn't always the material, the resources, the support for families. So that's where we see a bit of disconnect. On the one hand, you know, families are kind of here, seeing, having concerns. On the other hand, families aren't sure where to go or how to act on it. 

And then there's also a smaller body of work where we see that families may themselves have increased mental health issues relative to suicidality. So that we need to understand better but it's kind of, you know, I would say family families are more than a factor of risk, but they do there certainly is a lot of research that says okay, like, if you if you're married, that tends to be more supportive. If you are in a relationship breaking down, then that tends to be more of a risk. 

So you see how the same the same like family factor can play out in different ways. So certainly, the first two layers of the factors and then the intervenors. They're both in relation to the serving member or the veteran, right so like, the focus is on the person who's served. It's not really taking into account the person who's supporting them and the impacts that they're having. And so I would say it's a lot like the kind of classic idea of being on the plane and, you know, put the mask on yourself first, because you can't help other people but the tendency to help the other people you want to get there. And then if we don't support the spouse or the family, then they're not likely to be able to provide what the serving member needs. So we really have to both.

[24:25]

JH

Do you see the extended family taking a bigger role in sort of doing that support? Or is it mostly the spouse that's targeted by that? 

CB

Mostly it's, it's targeted more towards the spouse but it kind of gets a little bit vague on who they're assuming. In the in the factors, it tends to be like an intimate partner that gets focused on. But in the, in the we were expecting the family to kind of step up and do this. It's kind of an indiscriminate like expectation on whoever in the person’s family. 

CB

So Heidi, is there. Is there much research being done on this with the youth? 

[25:19]

HC:

No, there is a little bit of research - and I will also say there's no real Canadian research on this. So this is now we're interpreting what we see. There are some school-based programs that we see out of the US but the impacts on the youth, we have to do some further analysis to see why there's an increased sense of suicidality among military family members and what that's associated with. So that we don't know yet we're in the process of doing the analysis. But again, lots of questions. It's a starfish problem. Now I've got five more questions. 

JH

So this is happening at a research level and you and your colleagues are taking a look at this. How does your research get used to improve life for families? 

HC:

Well, I think this is where you know, conversations with people who are doing the program development, who are developing the policy. This is where things can change. So, when we're developing relationships with program developers and policymakers, then, you know, we're able to say these are the things that we're seeing. These are the things that matter. These are the things that we're seeing aren't being addressed. We are there opportunities to adapt current services and service models towards things that are coming out in the research as more and more relevant? 

Because what families need changes. The nature of what our Armed Forces has been engaged in has changed over time. So you know, the nature of the exposures and the things that they're dealing with and just like families in Canada have changed, all of these things have changed. So services also need to adapt. 

[26:45]

CB:

And hopefully, as a part of that is breaking down the stigma of getting support for the families. And we hear that a bit from the families, right. There's misconceptions from families that if I go to the MFRC, or any other organization that's connected to the base, does that put my husband's career in jeopardy? Will his chain of command ever find out that I've gone to see a social worker? Or will whatever comes up be shared with the chain of command?  You know, will this interfere with someone's promotion or hinder someone getting deployed or training? And in some cases, there's even families that have that feeling that you know I can't manage my own family because I need help. 

And I think that's something that we've been looking at trying to break that down for a very long time. That that is not the case whatsoever. You know, like families have their right to privacy, and none of that is shared with the chain of command. 

[27:52]

HC:

Yeah, I think that's important that, you know, these systems kind of run in parallel, but they don't intersect. So there's no naturally occurring point where those things come together. There's no policy or procedure that says notify this. 

I do think that if COVID has taught us anything is that we're all vulnerable, and that everybody needs help. And being able to reach out can be that lifeline, and to keep reaching out until you find the right kind of help that that matches with you. There is no one set of things that's going to make it better for everybody. So, you know, there needs to be different options for what people can access. 

And for some people, that's going to be the MFRC. For some people, it's going to be in the broader community. For others, it's going to be a blend and other people won't turn to any kind of formal support and we'll just, you know, look to their family.

You know, but family members are not - unless they're actually trained as like a psychologist or psychiatrist, and even if they are they really shouldn't be yours -family members are there to support you informally. They're not there to be your psychologist or social worker, you know, being able to find a social worker or psychologist when you need one actually is very healthy, to maintain your other relationships. And you can't look to your friends and family to provide clinical levels of support.  Because when you need it. You need it. And if you can figure out how to get it go, because these things don't spontaneously resolve. 

CB:

and if you don’t know ask …

[29:30]

HC: 

This is it-  it's not like a rash that was there one day and the next stage has gone. Oh, well, I don't know what caused that it's gone now. It's not like that. 

Mental health and mental wellness, you know, takes practice, takes resources. It takes it takes a lot of work to maintain it. And life is like distorted and disrupted with all of this.   Who knows what date is anymore - what time it is.  We’ve lost all of our kind of anchors to time and place and we're kind of floating through in this perpetual Groundhog Day. 

And you know, it's a great time to seek mental health services and supports. And to try and kind of be well and centered in yourself because if you're really trying to help other people. If you're not going to do it for yourself, then do it for the people you're trying to support, because everybody needs to kind of have that restorative support, to be able to give to others as well. 

[30:30]

JH:
So you've been doing this work for a while, knowing what you know now, if you were to give a military family or a military partner who's just getting into this life some advice on things that they can do to safeguard their relationship - to safeguard their family, what kinds of things should they be doing? 

HC:

You know, I think being able to have some sort of kind of ground rules on communication.  You know, the nature could work can be pretty rough, and it can impact people differently. And I think that's really important to know. And things that you experienced and do when you're 22 might seem like they just roll off a duck's back, but at 32 they might feel a bit different in you know, in reflection on those things. And then, I mean, you have to give space and time for those things. I think some of the biggest challenges that families experienced on a practical level around communication, and about transitions. 

If there were a magic formula and how to figure out how to say, okay, family, you got a challenge - your challenge is to create a very well-functioning system that doesn't need the person who's serving because they are managing fine without them when they're away. But yeah, when they're back, they have a meaningful role, and they couldn't possibly do it without them. So Boy, that's a sweet spot to really search for. 

JH:

And to make that switch within a day or two. 

HC:

Yeah, just it's (snapping noise)

Certainly, like as a fire family like, you know, I get that because we do it every time he goes to work you've gone for 24 hours, and then it comes back. So you're like, totally, it's all on you. You're doing it all you're carrying it all. You don't know what's happening at work for him, but then it comes back and it's like, okay, you have to like switch your role assignment. So to be able to kind of talk about that, and also recognize that the way that you share, and pass that baton back and forth will naturally change in the lifecycle of your family and in the kinds of ways in which each of your jobs might change too- and the demands there. So a lot of variables when we think about families, but one person, right, it's a whole bunch of people in their own personal trajectories, but also collectively through this trajectory. 

[32:25]

JH:

And I think we all have stories about that adjustment. My husband went on a deployment for about four months, just after we first got married. We’d been married about six weeks and he left and I was on my own for a couple of months. And he came home and he said: you know, do you what would make it easier when you were doing the laundry? I almost fell over. 

And I said So you know what? Congratulations, that sounds like a really good idea. Let me know how it goes when you implement that. And for the last 26 years he's been in charge of laundry. 

Jumping in with helpful suggestion.

CB: 

In some cases, having your husband do laundry can be very dangerous 

JH:

and expensive

CB

and expensive.

[33:15]

JH:

You talked about transition, how does it you obviously have to make a change like the biggest transition I guess is if you've made a life going back and forth, if you've made a lifespan having separate lives and together lives, then all of a sudden data in the military and they're there all the time, right? That's a huge transition for relationship. Do study that how that affects the relationship after the person's out. 

[33:35]

HC:

It has certainly come up. We recently completed a qualitative longitudinal study on transition and that was funded by Veteran Affairs Canada. And so, a longitudinal studies, we go back to the same people multiple times. So all of these people were serving members became veterans, so none of it from the perspective of family, but they have a perspective on their family. And the kind of time use and relationship changes. And, you know, what do we do now? 

In the broader retirement literature, we know that there's a period of transition for people where you know, somebody who was gone a lot is now home and underfoot from the regular rhythms. Like this person wasn't there, you know, a month ago and now that you're all the time and during COVID they're seriously always here, like always. And so it does come with challenges. 

And I think that trying to find, you know this goes back to my training as an occupational therapist. You know, what are the things that give you meaning, that give you purpose, that structure your time use. And when people are releasing from something that has been so central to who they are and how they see themselves in the world, in the community, in their families. You can't just kind of go off a cliff and go into nothingness, right. So it's how do you cultivate new occupations? Not jobs, but you know, the ways you occupy your time. How do you cultivate patterns of new occupations that give you some of that? Because that brings you kind of fulfillment as a human when you have that. 

I think it's normal. For people to take a period of time where there's no structure, going through the military life, someone's telling you, there's a lot of external requirements about where you are, and how long you're there. So I don't want to get up at a certain time I don't want to do that. I want to just be free. So you know, we see that that can be a pattern for people but it takes a while to figure out the new time use patterns. So have some patience. In the beginning. It's a massive of life change to go from being in a rank order command system, to being free of that and for some people it's almost disorienting, without it right? Because it's like, where's your True North now for figuring out how to use your time? 

[35:52]

JH:
And a lot of these things are pervasive in the family like our family jokes, but the fact that no one in our family is ever late because we have been raised with someone who is you know, if you're not five minutes early your 10 minutes late. We are used to somebody packing like two liters of water for every person, the whole one man when kit, it's so much part of your family culture that when they step out of it, it affects everybody. 

HC:

It does. And we see you know that people have families, front and center in their box of release. What is it going to mean for me and the kind of relationships I can now have with my family members here and you know, an extended community that I couldn't have had because of the nature of my job. So people are looking at those opportunities of how to build those things. They're looking at opportunities to create opportunities for say a spouse who has been a trailing spouse, and now it's the spouse’s turn to figure out okay, you know, you go and, and I'll dip down and you know, your career takes precedence. And then sometimes it's, you know, the kids are teens, and they don't want to be moving around anymore. And they want to kind of settle in this community because they really like it and everyone's doing well. They want to like freeze that moment in time. So you see all kinds of family-related drivers for people when they're thinking about releasing from the military.

[37:03]

CB:

Have you done much or has there been much research done on reservists families or reservists in general?

HC:

No, and that's an international issue. In the US there's been a body of work on National Guard, but a lot of the ways that the funding has come down for academic researchers, it's been to focus on regular forces. And we don't have that same access to reservist families. So when we've tried to include reservists, it's actually been hard to get at reservists for research purposes. But I think that they're not as familiar with to work that's happening. And then of course, accessing the families is always an extra layer of how to get families because there are no real direct pathways to reach family - of Reg forces or Reserve.

JH:

is there anything else that you want to add that we haven't talked about that you think it's important for families to know? 

HC:

You know, I've been talking with folks in my group, my research group as well about how do we understand what families need from researchers? How do we create opportunities to get more comfortable with it? You know, most people don't know a lot of researchers or haven't had the opportunity to talk to researchers. 

We want to be able to create some opportunities where you know, we could show up virtually and people can come for coffee and find out a little bit more. Like have a conversation like the podcast, maybe.

We were just people who have real strong interests. I think getting things for a long time. So we just want to talk about it. Like we get excited. I feel like we grow tall when we talk about it. I know that we we’re on audio but Julie and Claudia are probably laughing at all of my massive hand gestures that I'm showing you like where things are in my mind. And you know, I mean, there's a real energy to the work that we do. And I think that as a community of researchers, we really believe this as the social mission that we're this is all for service to communities through research. And, you know, I do believe, you know, in the concept of, you know, what CIMVHR envisioned around like, how do we use research to really improve the lives of people who serve and have served and the family?

CB:

There’s a lesson in there in how do we take your research and use it to provide the supports and services from an operational level and I just want to say to you the breadth and the depth of the research that you've been doing over the past few years, you know, four or five, I think longer, probably from the CIMVHR conferences is amazing and so critical in opening our eyes to the importance of what we could be doing more of. Just getting the information out there. So thank you, to you and your team, and everybody had CIMVHR and all of the other collaborating partners that you're dealing with. I look forward to this information. But I will say I also enjoy it more when you're doing your summaries and it's in English so I can understand it. And not in researcher language.

[40:00]

HC:

Well, that's it, you know, I think that we can create some opportunities - and thank you for the positive feedback on it.  It has taken a long time.  Deb Norris wrote that article was published in 2015. So about, you know, the state of military family health research, and we kind of charted course and you know. What is it we can do where do we go with this and, and just kind of plugging away at trying to get at these issues. And the issues starfish.  Linda Manser has been great, you know, we had this engagement session last January or February.  And you know, it's because of the work she had done, where she said, you know, this is what military families are looking like, and you know, what if we try kind of doing an engagement series that was one for Army, one for Navy, one for Air Force?  And we hadn't done that yet, because we hadn't got to a point where we differentiate. There wasn't enough research there for us to start to ask a deeper, more differentiated questions. And wow, what a great idea, right to see that, you know.  And COVID - COVID impacting those differently because of the way that those particular sectors were getting pulled in. 

So I think it's great to be able to continue to look at how are we are the same, how we are unique across things, so that we can better inform each other and policy. Because that's what it comes down to a bunch of applied researchers. We're not asking questions just because we're curious, right? We're asking questions because we want to get what we need to make it different than he did back to the people who are in the decision-making place. 

JH:

So those people who share their stories participate in the research. They're laying the track to make things better for future generations for military spouses coming after them when that policy finally comes through. 

HC:

Oh 100% Right. So you know, when people participate in research, they're part of future solutions. It might not benefit them in their current state, because research does take time and so does policy change, but it is part of a bigger collective energy. 

JH:
And we always say that you don't know what it is until you've lived it. So you know, speak up, make sure people know what your experience is.  And they're not going to fill in the blanks. They're not going to be able to guess what your life is, but you can tell your story and you can really add to that conversation. 

Thank you so much, Heidi for joining us. We've really appreciated learning more about your research. We're going to share all of the information about CIMVHR, about the family matters research group in the show notes so you can follow along keep track of the things that Heidi is doing and the questions that she and her fellow researchers are asking. Thanks again. We've enjoyed speaking with you. 

HC:

Thanks so much for having me.

CB:

Thanks, Heidi.