01/16/2014 11:13 am ET Updated Mar 18, 2014

The Fall of Fallujah and Its Effect on Vets

JOHN GOMEZ via Getty Images

When the news hit about an al Qaeda-affiliated force taking control of Fallujah, I knew I'd be hearing from vets, especially the Marine vets in Florida I'd known since 2008 when a buddy of theirs, whom I'd treated for PTSD here in Los Angeles, asked me if I'd work with them and then handed me a plane ticket to Florida.

Originally a group of nine, one was now in prison, two were suicides, and one had been killed in a shoot-out. The five surviving vets called my personal cell. The news of Fallujah's takeover had completely reactivated their PTSD symptoms. All they'd fought for was now in danger of being lost, which gave rise to questions about what it had all been for -- the blood, the sacrifice, the loss of comrades. I knew they were filled with anger, frustration and a sense of meaninglessness. Was our sacrifice for nothing? Was there no meaning to the losses?

They weren't the only ones who called. And I'd seen this before. In 1975 when Saigon fell, Vietnam veterans in and out of treatment experienced the same return of full-blown PTSD. In 1991, when the Gulf War was declared, what I call "war energy" from reports of chemical warfare and weapons of mass destruction kicked off waves of anger and frustration that brought a recurrence of PTSD symptoms in Vietnam vets as they imagined young men going off to war as they had done.

I made the first of three trips out to Florida to meet these nine Marines in 2008. In 2010, I met with the Marines and their family members, including three former wives and several sets of parents -- a perfect illustration of the collateral fallout of war trauma. It's not just the nine vets anymore -- it's their families and loved ones as well.

For the vets, the questions that rise repeat and repeat, are an endless loop triggered by news items, incidents in daily life and news like this from Fallujah. The internal conversations go on and on. For us, the general public, it's just another news bite. For them, it never stops. No one can predict whether vets will implode or explode. Don't be surprised if this current news story triggers some incident here in the U.S., in some small community, some family.

One of our Lifeline for Vets counselors at the NVF is a four-tour veteran of Iraq. Asked what his feelings were about the takeover of Fallujah, he said it was a slap in the face to those who had served and sacrificed. He felt that it was an ungrateful gesture on our part to every Iraqi who'd stood with us against the insurgents, everyone who'd said, "We're glad you're here."

Of the war in Iraq, he says that he and many others were willing to write that blank check to lay down their lives for something that was bigger than them.

"I gave them my youth," he said.

He's one of the 60 percent who made it back, who struggle with the transition back into civilian life, but make it. For 40 percent, the struggle never ends. What's happening at this moment in Fallujah will have long-term effects whether or not Fallujah falls.

Society as a whole is de-sensitized to the Iraq war -- news of it is insignificant in our consciousness. But every headline like Fallujah, every time a helicopter goes down, every time an Afghan soldier turns on his trainers, reverberations travel through the population of vets from the most current war back to previous wars.

The flood grows.I know that sometimes our NVF counselors feel like we're just a few sandbags against a flood of emotions when we need dams to be built for people to be able to address this. We need the community to take responsibility. The first step is awareness. That's why I'm here talking to you.