It's better to run towards the fire: The experience of reserve duty for reservists with PTSD prior to re-enlistment

Background: Little research exists delineating the experience of serving in the military with PTSD despite longitudinal studies indicating that a small percentage of deployed combat soldiers have PTSD prior to deployment. Following a mass re-enlistment of reserves, during the Iron Swords war, the current qualitative study aimed to describe the experience of fifteen reservists with pre-existing PTSD and explore the clinical difficulty or utility of their service. Methods: Reservists were interviewed by trained clinicians and interviews were transcribed and analyzed using a grounded descriptive phenomenological approach. Results: Findings demonstrated a key theme of a reparative experience in addition to the differentiation between functioning on the domestic and military front and the differentiation between the fantasy of success versus the reality of re-enlistment with PTSD. The experience of re-enlistment as a reservist compared to the original PTSD-inducing service was described in terms of enhanced capability, a greater awareness of emotional needs by seniors and the establishment in general, enhanced choice (including that to re-enlist) and the utility of PTSD symptoms such as hyperawareness, on the battlefield compared to the futility at home. Conclusions: The study highlighted the unknown nature of repeated duty and the potential for increased difficulty of transition between military and domestic spheres while acknowledging the potential for a positive experience of re-enlistment with PTSD. The findings reinforced the need for clear clinical guidelines within the military and importance of monitoring for risk of deterioration of symptoms both on the battlefield and following discharge when enlisting those with PTSD.