Remembering the Psychological Impact of War... and Doing Something About It This Emotional Life - PBS

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 Dr. Barbara  Van Dahlen

Dr. Barbara Van Dahlen's Bio

Barbara Van Dahlen, founder and president of Give an Hour™, is a licensed clinical psychologist

Remembering the Psychological Impact of War... and Doing Something About It


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On September 11, 2001, our nation went to war—first in Afghanistan and later in Iraq. Nearly nine years later the war rages on and the men, women, and families in our military community continue to experience the consequences of this war.   

Although we have all seen the news reports and read the articles explaining the human cost of war, as a country we seem to still struggle to grasp the enormity of the situation for the men, women, and families who serve. There is no doubt that Americans want to support our men and women in uniform. We are clearly proud of their service and appreciate their sacrifice. But far too many of us lack the knowledge and understanding necessary to truly assist in the reintegration of our returning troops into their—and our –communities.

How can we understand this disconnect? What makes it so difficult for us as a nation to recognize and respond to the reality of war for those who serve? And, most important, what can we and our leaders do to effectively and comprehensively care for our military personnel and their families?

One reason we struggle to grasp the true impact of war on those who fight is the nature of that impact. It is relatively easy for us to recognize the effect of a physical injury. We may feel uneasy or uncomfortable at the sight of a young man or woman who is missing a limb as a result of his or her service, but at least we can see the injury. At public events we routinely applaud all of the wounded warriors who have returned home. We support programs and encourage funding to care for those who have suffered physical injuries. For many of those who serve, however, the injuries are invisible. Yet these unseen injuries have far-reaching implications for a soldier’s ability to function here at home. These invisible injuries can and often do affect the ability to work, play, sleep, study, love, parent, relax—in short, to be.

Perhaps the primary reason for our difficulty in responding effectively to the needs of those coming home from battle is our discomfort with mental health issues in general. Journalists and others repeatedly ask about the “stigma” that prevents those in need of care from seeking service. Unfortunately, our society—our culture—is poorly equipped to respond to the needs of citizens grappling with mental health issues. We continue to perceive those in need of mental health care and support as weak, less competent, less capable, or less effective than those who do not seek such care. Ironically, psychological struggles are normal and punctuate everyone’s life and experience. We have all experienced stress and self-doubt; many of us have felt depressed, anxious, overwhelmed. Many of us have experienced loss and pain and  been affected by trauma. And yet, we continue to shrink from conversations about these issues—perhaps because the conversations themselves elicit feelings that remind us of our own psychological struggles, challenges, and pain.

Yes, we are definitely uneasy with the conversation about the psychological impact of war on those who serve. Maybe we feel guilty for subjecting those who serve to possible psychological injury in the first place. Maybe we sense that the consequence of this type of injury can be more devastating than a physical injury. Maybe we have a collective memory of the generation of Vietnam veterans, who came home from war with demons that plague them to this day.

No matter what the reason, if we are aware that war can lead to psychological injury, if we have research that confirms this, then we should do all that is within our power to educate ourselves so that we can effectively support those who serve and their families—so that we can ease their pain, normalize their experience, and guide them through what can be a very difficult journey home.  

What do we know about the impact of war on those who fight and those who love them? Why are some individuals affected severely while others seem to have greater resilience? The good news is that we know quite a lot. For example, we know that war affects all who experience it – of course it does. This doesn’t mean that everyone comes home with severe post-traumatic stress; nor does it mean that everyone coming home experience severe family problems. But, as we would expect, all warriors must come to terms with their experience of war—what they saw, what they did, what, perhaps, they weren’t able to do . . . Intense experiences shape and change those who experience them. Sometimes those who go to war become fearful, angry, withdrawn, distrustful, avoidant. Sometimes they come home with more commitment, more dedication, more passion—for an issue or for life. Change is a certainty for all who experience combat. A dear friend who is also an Iraq war veteran explained it best. He said that all who come home from war bring it home with them: the pain they experience is a reflection of their humanity. We should embrace them for sharing it with us.

We know that the effect of war on any single individual is influenced by multiple variables, some that a service member may control but many that he or she does not. For example, we know that prior history of trauma results in a greater likelihood of developing symptoms as a result of subsequent trauma. This is why those who have been deployed to war multiple times are at greater risk for developing difficulties. We know that loved ones—spouses, children, parents, siblings, friends—can and often are severely affected by the indirect impact of war. And why wouldn’t they be? We know that if we enter the equation early, if we help those affected to understand what has happened and is happening, we can greatly diminish the severity of the psychological injuries of war.  

Thankfully, our administration and our military leaders recognize the importance of caring for the long-term needs of our military community. Thankfully these same leaders recognize the importance of coordinating efforts with community-based organizations—organizations not of the military but formed outside the military to provide additional care and support to the men, women, and families who serve. On May 5, President Obama signed into law the Caregivers and Veterans Omnibus Health Services Act of 2010. This law, he first of its kind, includes provisions to support the caregivers of seriously injured Iraq and Afghanistan veterans. In addition, it improves services for our nation’s 1.8 million women veterans and expands the availability of health care for all veterans.

In recent weeks the Chairman of the Joint Chiefs, Admiral Mike Mullen, has expressed similar sentiments about the need for community involvement in efforts to care for those who serve: “There is a huge list of needs, growing needs. It cannot be met by the Pentagon. It cannot be met by the VA. It can only be met, I believe, by the community groups throughout the country joined together with the Pentagon and the VA to get it right for those who’ve sacrificed so much.”  He has also noted that most returning troops “want what every other American wants: to lead productive, independent lives, to provide for their families, and to raise their children to a higher standard of living. The government helps with all that, to be sure, but it cannot—and should not—try to supplant the millions of ways in which a soldier’s family or neighborhood or hometown can make those dreams come true.” The sea of goodwill “is out there,” Admiral Mullen said, “I am just trying to find ways to better connect our veterans to it.”

Then, on May 12, our First Lady announced the following call to action: “I am issuing a national challenge—a challenge to every sector of American society—to mobilize and take action to support and engage our military families. We need a truly national commitment here.”

Clearly, our leaders are ready to take action. Clearly, they expect that we will all do our part in this effort. Thankfully, our citizens have repeatedly demonstrated compassion and generosity for those in need. Our job now is to educate our nation and to provide a blueprint for how we can all come together to support the men, women, and families who do so much and ask for so little.