PBS 'This Emotional Life': Addressing the Psychological Impact of Combat

10/25/2010 09:36 am ET | Updated May 25, 2011
  • Barbara Van Dahlen, Ph.D. Founder and president of Give an Hour, the backbone organization of the Campaign to Change Direction

Unlike the Vietnam veterans, this generation of warriors is coming home to a country that wants to support them. We don't blame them for our government's foreign policies, we recognize the sacrifices they make, we applaud them for their courage and bravery, and we proudly display magnets on our cars and refrigerators. And yet, we continue to see story after story indicating that those who are coming home -- and their families -- are suffering. Suicide among military personnel is higher than it has ever been and according to some studies, significant mental health issues affect as many as 35 percent of those who see combat.

Unemployment rates are higher among our returning veterans than for civilians, and this generation of veterans is becoming homeless at a much faster rate than their predecessors. In addition, military children are being seen for behavioral difficulties at record rates, and divorce within the military community is on the rise. What is going on?

The Departments of Defense and Veterans Affairs are spending millions of dollars to address the consequences of repeated deployments and reintegration. Nonprofits, foundations, private corporations and veteran service organizations are pouring money, resources and time into addressing the needs of those who serve and their families. The current administration has been steadfast in its support of our military community: Our First Lady and Vice President Biden have been tireless in their focus on the issues affecting the men, women and families who serve. Clearly, some of the brightest minds in our country are working to address this growing public health crisis. Yet, thus far we have been unable to provide the support and services necessary to ensure that those coming home and the families who love them are able to rebuild their lives, raise their children and realize their dreams.

Our efforts, however, have been successful in some key areas of care. Medical advances have allowed tens of thousands to survive who would have died on the battlefield during prior conflicts. Prosthetic devices are now engineered with impressive sophistication, flexibility, and durability. They allow those who might otherwise be severely disabled and dependent to lead more self-sufficient and productive lives.

In addition, there is much that we understand about the psychological impact of combat on those who serve. Not all who go to war return home with devastating emotional injuries, but all are affected. We know that post-traumatic stress is a natural human reaction to horrific events and that the development of this reaction is neither a sign of weakness nor a defect. Furthermore, we know that these invisible injuries of war affect every aspect of life, from employment to education to family functioning. And we know that repeated exposure to trauma increases the likelihood of developing severe and chronic mental health symptoms.

Sadly, we also know that secondary trauma is a real and potentially devastating phenomenon that can affect family members when the aftershocks of trauma go untreated in a loved one.
We have seen that a significant portion of our troops are coming home with traumatic brain injuries (TBIs) owing to the frequent exposure to blasts resulting from improvised explosive devices (IEDS). Although functioning can improve following a mild TBI such as a single concussion, many who come home have had multiple concussions and report ongoing difficulties including problems with concentration, memory, impulse control, depression, substance abuse, anger and hearing loss. Moreover, many of those who suffer a TBI also experience the distress of other significant mental health challenges.

Perhaps the most critical bit of information that we currently possess about the impact of combat on those who serve is that early intervention, education and treatment are critical if we are to prevent severe and long-term damage and dysfunction. So why has our nation been unable to provide it to the men, women and families who sacrifice so much and ask for so little in return?

Our society does a poor job of addressing psychological pain and suffering. Indeed we humans seem to have a difficult time addressing our own mental health needs. We are uncomfortable, awkward and afraid of what we can't see or control. In addition, we are not very skilled at coordination or collaboration. We are a society of specialization -- a nation built on rugged individualism. We prefer to work in our own lanes, silos and stovepipes. We don't trust easily. We don't like to share information or credit, and we resist relinquishing power.

But if we are to properly care for our returning troops and their families, we must evolve. We must create a comprehensive and integrated system of care that recognizes and addresses the pervasive and potentially devastating impact psychological trauma has on a military community that has borne the brunt of nine years of conflict.

Fortunately, there are signs that we are making progress and that our citizens and our communities are ready to accept this challenge. The Chairman of the Joint Chiefs of Staff, Admiral Mike Mullen, speaks frequently and compassionately about the need to wrap our communities around the men, women and families who serve. He notes that there is a "sea of good will" across our country, which must be harnessed and channeled.

In addition, a number of leaders representing the nonprofit community , veteran service organizations, and the government have come together to create an initiative aimed at assisting our communities in their efforts to care for our military community. These leaders have parked their egos at the door, rolled up their sleeves and created what is being called the Community Blueprint: a simple yet potentially powerful tool that may encourage a much needed shift in how we understand and care for those who fight our wars. The Community Blueprint is not a silver bullet, and many communities have already made significant steps to organize themselves in creative and effective ways. But the Community Blueprint is a vision, a belief and a hope that our nation is ready, willing and able to provide the real opportunities, as well as the comprehensive and integrated care, that our military families need and clearly deserve.

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