After The War Zone: Returning Troops and Their Families
By Laurie B Slone, PhD and Mathew J Friedman, MD, PhD, 2008
Frequent Combat Experiences include being attacked or ambushed, receiving incoming fire or being shot at, discharging their own weapon, seeing dead bodies and remains, knowing somebody who has been seriously injured or killed and feeling in grave danger of being killed.
Switching Gears can be difficult. Something to help is the BATTLE MIND Acronym:
B=Buddies or Cohesion vs. withdrawal
A=Accountability vs. Control
T=Targeted vs., Inappropriate Aggression
T=Tactical Awareness vs. Hypervigilance
L=Lethally Armed vs. Locked and Loaded
E=Emotional Control vs. Detachment
M=Mission Operational Security vs. Secrecy
I=Individual Responsibility vs. Guilt
N=Non-Defensive Driving vs. Aggressive Driving
D=Discipline and Ordering vs. Conflict
Spouses can also have a difficult time adjusting. There is a BATTLE MIND Acronym spouses.
B=Buddies (Social Support with others)
A=Adding or Subtracting Family Roles
T=Talking It Out
L=Loyalty and Commitment from Both Partners.
M=Mental Health and Readiness
N=Navigating The Military System
D=Denial of Self or Self Sacrifice
Chapter 5 Discusses Common Reactions to the Trauma of War. Soldiers who have returned from war may experiences: trouble sleeping, trouble eating, upset stomach, headaches, bad dreams or nightmares, poor diet, poor health, rapid heartbeat or rapid breathing, existing health problems may get worse, trouble concentrating, are jumpy or easily startled, being on guard or always alert, excessive drinking, drug use, flashbacks, avoiding triggers, irritable, often angry, shock, numbness, easily annoyed, helplessness, mistrust of others, emotional shutdown, detachment, becoming controlling or overprotective of loved ones and having lots of conflicts.
All Soldiers experience these symptoms after combat, but many find it only temporary. If the symptoms listed above persist and continue on long-term than they may receive the diagnosis of PTSD or Post Traumatic Stress Disorder.
Friends and Family will often try to be helpful, but they may say things that make it worse. If you are dealing with a loved one who has PTSD don’t put pressure on them to talk and don’t tell them to shut up if they are able to talk to you. Don’t use clichés like, “War is Hell.” Don’t say it will be okay or it could have been worse. Essentially, try and not to invalidate or belittle their experiences.
Chapter 6 talks about how Anger is the most common issue returning veterans face. Why? Anger is easy. It is easy to get angry at others in the civilian world for not listening or obeying orders. When they don’t do what they are supposed, there is no recourse. Angry often stems from trust and betrayal issues. Anger is in response to being victimized. Anger also comes from feeling fear and a loss of control. Anger cause can be caused by Physical Issues as well.
Chapter 7 discusses Guilt and Moral Dilemmas. Many Veterans suffer from Survival Guilt. Hindsight of the events is biased. They feel like they were given a test of faith in the foxhole. They ultimately feel responsible for the outcome even if they had no control over it. Grief is a normal response death and loss. Grief can become Traumatic Grief when the loss is sudden or violent.
Chapter 9 covers Reconnecting with a Partner, Family, Children and Friends. The authors suggest avoiding the pattern of withdrawal and isolation. It is important to reestablish trust and intimacy. Talking through anger and not exploding can aid in this process. General Communication skills often need improved to avoid further conflicts.
Chapter 11 deals with Post Traumatic Stress Disorder specifically. The first month after the trauma nearly everyone suffers from Acute Stress Disorder. The problem occurs if this state lasts longer than a month. Anxiety and Depression that lasts two months or longer is a problem that needs treated. They will have triggers that keep them re-experiencing symptoms over and over. They may even try to avoid the memories, feelings and triggers. PTSD is NOT a weakness though.
PTSD can negatively impact family and friends. The Veteran may change and seem like an entirely different person. Those around the Veteran who suffers from PTSD may suffer from Depression as well as drug and alcohol abuse.
PTSD treatment includes talk therapy and medication. Selective Serotonin Reuptake Inhibitors or SSI’s may be the first line the defense against the overwhelming feelings. Sometimes CBT or Cognitive Behavior Therapy is recommended. There is also Exposure Therapy which helps them regain a sense of control. EMDR is Eye Movement and Desensitization Therapy. CPT is Cognitive Processing Therapy. Also, yoga and meditation have been shown to help.
The last couple of chapters suggest that you learn to recognize anxiety, depression and suicidal thoughts. Recognizing Panic Attacks and GAD or Generalized Anxiety Disorder can also be helpful. Learn to recognize drug and alcohol abuse. Violence and physical abuse can also become a huge problem for some. Notice the physical effects of PTSD-related issues—including pain, fatigue, sleep problems, muscle cramps, rapid heartbeat, shortness of breath and chest pains.
Sometimes TBI or Traumatic Brain Injury can cause or add to PTSD. A brain scan and other tests can help determine if this is a contributing factor or not.
In any case, the book stresses how important it is to seek mental and physical help via the Veteran’s Administration and other Community Groups.
Overall, I found the book easy to read and good resource. The only complaint I have about the book is that I would have liked to have seen more on alternative therapies.