Table of Contents
Abstract
Living with a person who served as a military service member may be a severe challenge. Post-traumatic stress disorder is characterized by a variety of somatic and psychological symptoms. They cause sufferings not only to the person with PTSD but to the family members as well. Military individuals with PTSD require timely and professional help. They need support. After all the distress and traumas they had, veterans undergo the new crisis of adaptation. The suicide rates among the military service members are frightening. Widely they suffer from substance abuse and may be homeless. The children and wives of the veterans widely have depression and suffer from anxiety. A spouse of the veteran may be injured unintentionally or deliberately. Through this study, the statistics and overview on the issue are provided. The symptoms are considered. The two main valid approaches to dealing with PTSD include psychological and religious methods. Psychologists may work in a variety of theoretical frameworks and methods including cognitive-behavioral therapy, desensitization, etc. PSTD, surprisingly, may enhance the power of faith. Some of the individuals with PTSD become more zealous in their prayers and practices. However, another part may depict the loss of faith and beliefs that God is wrathful. Positive religious coping correlates with the increased psychological health, while negative religious coping corresponds to poorer psychological health
Living a military life is a challenge not only to a person but to the whole family as well. A non-military partner may suffer not less than the spouse who participated in the war. Mental health undergoes a solid pressure. Spouses of deployed military members encounter a higher risk of getting into specific psychiatric conditions. Through this assignment, the symptoms of PTSD are considered and overview regarding the issue among military service members and their families is provided. Two approaches to dealing with PTSD, psychological and religious, are considered to show that they are both valid for treating PTSD.
We can do it today.
Military wives who have deployed husbands often struggle with anxiety and depression compared to wives of non-deployed husbands (“Children, Spouses of Military Members at Increased Risk for Mental Disorders”, 2013). Being a military spouse may mean that mental health may be injured by a partner’s violence. It can be deliberate or not. Sometimes a spouse may fall in an abusive rage. Also, a veteran may experience a flashback which may be frightening or violent; he or she may even strike own partner unintentionally. Considering the noted issues, it is seen that the members of the families of the military service members fear for own which may lead to anxiety, depression and feeling of helplessness. (Children, Spouses of Military Members at Increased Risk for Mental Disorders, 2013)
According to Substance Abuse and Mental Health Services Administration, there are “an estimated 23.4 million veterans in the United States, and about 2.2 million military service members and 3.1 million immediate family members” (“Veterans and Military Families | SAMHSA – Substance Abuse and Mental Health Services Administration”, 2014). Due to the experience they had, many of them experience distress, have mental disorders and use substances. They may suffer from trauma, homelessness, criminal issues (“Veterans and Military Families | SAMHSA – Substance Abuse and Mental Health Services Administration”, 2014). They may suffer from insomnia, nightmares, agoraphobia, bereavement due to a loss of a comrade; they might have encountered a sexual assault from another service member (Moore & Jongsma, 2015). Individuals may suffer from a lifetime PTSD (Moore & Penk, 2011). Definitely, such issues inevitably influence the individual’s environment. Many of them commit suicide.
The Army suicide reached the maximal peak in 2012: “In the 5 years from 2005 to 2009, more than 1,100 members of the Armed Forces took their own lives, an average of 1 suicide every 36 hours” (“Veterans and Military Families | SAMHSA – Substance Abuse and Mental Health Services Administration”, 2014). According to the Veterans Health Administration report (January 2014), the suicide rate is much higher among veterans and military service members than the general population rate (Kemp, 2014). 22 veterans die by suicide every day. Three out of five of them were diagnosed to have a mental health condition (Kemp, 2014).
Around 76,000 veterans were found to be homeless on a given night in 2009; “136,000 veterans spent at least one night in a shelter during that year” (“Veterans and Military Families | SAMHSA – Substance Abuse and Mental Health Services Administration”, 2014). Treatment Episode Data Set (TEDS) report has shown that about 70% of homeless veterans have a substance use disorder (“The TEDS Report”, 2014). The same research also depicts the negative effects that deployment stress can have on wives and children. Children widely have emotional difficulties. Wives have mental health diagnoses (“The TEDS Report”, 2014).
Approximately a half of all the returning service members seek treatment for mental health as they need it. However, only a half receive adequate care (“Veterans and Military Families | SAMHSA – Substance Abuse and Mental Health Services Administration”, 2014). A lot of veterans choose not to use those services because of the fear of the harm that may be caused to their military career – or the career of the spouse. Ignoring the probable help they might have received enhances the risk and severity of PTSD.
Another issue that has to be considered a caregiving role a military spouse may have. As the veteran return home with PTSD, depression and other mental condition, it definitely influences their abilities as a caregiver. Caregivers have higher levels of depression than non-caregivers (“Children, Spouses of Military Members at Increased Risk for Mental Disorders”, 2013). The mental health of military children is another question. kids with a deployed parent frequently depict behavioral disorders (“Children, Spouses of Military Members at Increased Risk for Mental Disorders”, 2013). School-aged children have a higher risk for social and psychological problems. These children may suffer from anxiety, depression or isolation. They have problems with long-term friendships. They may feel that other children do not understand how is it to be a child of a deployed parent.(“Children, Spouses of Military Members at Increased Risk for Mental Disorders”, 2013).
Post-traumatic stress disorder is the most common form of disorders in victims of extreme events, which is most difficult to treat and correct. Is manifested by psychological, social and somatic changes. The duration of the post-traumatic stress disorder is from several weeks to several decades (Shalev, 2009). The people who suffer from post-traumatic stress disorder include participants in extreme events, family members of participants in extreme events, rescuers, physicians, journalists. Clinical manifestations of post-traumatic stress disorder are extremely diverse and may change with time. In the somatic sphere, posttraumatic stress disorder can manifest itself in insomnia, uncertain pain in the heart, in the abdomen, headaches, flatulence, diarrhea, dry skin or, conversely, increased skin fatness. Other symptoms may include trembling of hands, chilliness (“Post-traumatic Stress Disorder (PTSD)”, 2017).
In the psychological sphere, post-traumatic stress disorder gives the following picture: irritability, changing the character, depression, changing habits, deceleration of reaction or, conversely, acceleration; fears, obsessive thoughts, words, actions (as a rule, they are connected with the extreme event that took place), addiction to alcoholism and drug addiction, lack of vision of your own future, suicidal thoughts and actions (“Post-traumatic Stress Disorder (PTSD)”, 2017).
There are diagnostic criteria for post-traumatic stress disorder.
Criterion A. Two mandatory characteristics:
- Traumatic event.
- Feeling of helplessness and fear at the time of a traumatic event.
- Criterion B. A traumatic event is repeated persistently in a person’s experiences, which is accompanied by a vegetative reaction and fear (d’Ardenne & Heke, 2014).
- Criterion C. Constant avoidance of thoughts, feelings and actions related to trauma.
- Criterion D. Changes in the somatic sphere.
- Criterion E. Social change.
The diagnosis of post-traumatic stress disorder is not earlier than 1 month after a traumatic event with the mandatory presence of category A categories and at least three signs of the remaining categories (Friedman et al., 2011).
There are many approaches to treat posttraumatic stress disorder: cognitive processing therapy, eye movement desensitization and reprocessing, virtual reality exposure therapy, psychodynamic therapy, couple and family therapy, and group therapy; psychopharmacological treatment is used as well (Moore & Penk, 2011). Beginning of the treatment of post-traumatic stress disorder should be as early as possible and implement it in a comprehensive and long-term. Progressive muscle relaxation and cognitive-behavioral psychotherapy are shown to be effective. High efficiency shows self-help groups and mutual help.
Post-traumatic stress disorder is dangerous with suicidal outcomes, desocialization, drug addiction. So, among the former soldiers who fought in Vietnam, during the next 20 years after the war, there were more suicides than all the soldiers perished during the Vietnam campaign itself. The majority of the marriages of these soldiers broke up, almost all suffered from depression, many – alcoholism, drug addiction, convictions. Post-traumatic stress disorder cannot be prevented as, in most cases, it is impossible to avoid anthropogenic or environmental disaster. However, early psychological support contributes to frequent self-healing from post-traumatic stress disorder in later periods. Such assistance should be provided to everyone, regardless of how the victim suffered a catastrophe since the severity of the post-traumatic stress disorder does not depend on the primary reaction (“Trauma-Informed Care in Behavioral Health Services”).
The transition from war to peace, “stress of return”, “demobilization syndrome” can be no less traumatic than the very participation in hostilities (Polusny et al., 2011). The presence of an incorporated traumatic reality after return generates a so-called perceptual dissonance, embodied as a result of the coexistence of two systems of perception of reality. In such conditions, the role of the family as a post-stress environment is extremely important in identifying violations, in countering trauma, in facilitating the reproduction of past experiences and in resolving conflicts. But the family can be both therapeutic and provoking the development of posttraumatic states factor. The trauma of one family member has a direct impact on the others, since the interaction of the family and the traumatic situation is not one-sided.
The role of faith considering individuals who suffer from PTSD as well as their family members is essential. It is found that positive religious coping is connected with the increased psychological health, while negative religious coping correlates with poorer psychological health (Freeman, Moore, & Freeman). There are two major ways in which trauma may change the faith. On one hand, there is a phenomenon called adversarial growth or posttraumatic growth (Freeman, Moore, & Freeman). Survivors of trauma may start to pray and to visit church more frequently as it may serve as a coping method. On the other hand, some of such individuals with traumatic experience may turn away from the faith and religious practices (Freeman, Moore, & Freeman). Moreover, they may even start considering God as wrathful (Freeman, Moore, & Freeman). Spirituality may be bothered by the trauma, yet, spirituality positively correlates with better quality of life. So far, it may be assumed that faith may be a powerful aspect to increase resilience among the military veterans and their families.
The views of the Bible on war may seem controversial to some extent. The basic words on war can be found in the sixth commandment “Thou shalt not kill” (Exodus 20:13) and “You have heard that it was said, ‘AN EYE FOR AN EYE, AND A TOOTH FOR A TOOTH.’ “But I say to you, do not resist an evil person; but whoever slaps you on your right cheek, turn the other to him also” (Matthew 5:38-39). At the same time, there are many verses in the Bible which point on the issues regarding war showing no restriction on war. It is seen that for some times and events war was inevitable and even needed. Nevertheless, war is always the result of sin (Romans 3: 10-18). God often commanded the Israelites to start wars against other nations (1 Samuel 15: 3; Joshua 4:13). God ordained a fatal punishment for many crimes (Exodus 21:12, 15; 22:19; Leviticus 20:11). So, God is not against murder in general, but rather against willful killing. War is by no means a good thing, but sometimes it is necessary. In a world full of sinful people (Romans 3: 10-18), war is inevitable. Sometimes the only way to prevent the great damage done by sinful people is the war against them.
“A time to love, and a time to hate; a time of war, and a time of peace” (Ecclesiastes 3:8). Some wars are more “justified” than others, but they are always the result of sin. Christians should not want war, but also should not resist the authorities set by God over them (Romans 13: 1-4, 1 Peter 2:17). The most important thing we can do during the war is to pray for Divine wisdom for our leaders, for the safety of our soldiers, for a quick resolution of the conflict and minimal losses on both sides of the conflict (Philippians 4: 6-7). Jesus gave his life for us, he did not want to kill for us. Moreover, the understanding of freedom by Jesus was not limited to the freedom of the oppressed from the oppressor. Jesus gave his life just like the oppressor, for the sins of the whole world, and not just for the weak at the mercy of the powerful. Jesus wanted freedom for the oppressor and the oppressed. As an Israeli, he was well aware of the human experience of those who rebelled to take power from their oppressors only to become themselves oppressors themselves. Jesus showed the third way – how to avoid an endless cycle of violence, refusing to contribute to its continuation.
There are many verses that are aimed at enhancing resilience. The belief that there is a higher source of power, God who rules the life and invites to His glory may be very supporting for the religious veterans who suffer from PTSD. The Bible teaches to be brave: “Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the LORD your God will be with you wherever you go.” (Joshua 1:9). Also, it encourages to rely on God in any circumstances: “Trust in the LORD with all your heart and lean not on your own understanding; in all your ways acknowledge Him, and He will make your paths straight” (Proverbs 3:5-6). Such knowledge is essential for those who might have lost hope. Finally, there is an inspirational verse for all those who need hope for resilience after the dreadful events “…Weeping may endure for a night. But joy comes in the morning” (Psalm 30:5). This verse reminds that no suffering may last forever. Hope is a key to a better life. This is true for both service members and their families.
To summarize all the before-mentioned, not only veterans suffer from mental issues but their families suffer as well. There are many ways to address PTSD, both psychotherapeutic and religious. The best option is to combine the two. Not only service members require help but the members of their family equally need it. Applying the methods of psychotherapy and enhancing faith may help to save the lives and enhance well-being.
- d’Ardenne, P., & Heke, S. (2014). Patient-reported outcomes in post-traumatic stress disorder Part I: Focus on psychological treatment. Dialogues in clinical neuroscience, 16(2), 213.
- Freeman, S. M., Moore, B. A., & Freeman, A. (2009). Living and surviving in harm’s way: A psychological treatment handbook for pre- and post-deployment of military personnel. New York, NY: Routledge. ISBN: 9780415988681.
- Friedman, M. J., Resick, P. A., Bryant, R. A., & Brewin, C. R. (2011). Considering PTSD for DSM‐5. Depression and anxiety, 28(9), 750-769.
- Kemp, J. E. (2014). Suicide Rates in VHA Patients through 2011 with Comparisons with Other Americans and other Veterans through 2010. Washington, DC: Veterans Health Administration.
- Moore, B. A., & Jongsma, A. E. (2015). The veterans and active duty military psychotherapy treatment planner (2nd ed. with DSM-5 Updates). Hoboken, NJ: Wiley. ISBN: 9781119063087.
- Moore, B. A., & Penk, W. E. (2011). Treating PTSD in military personnel. New York, NY: Guilford Press. ISBN: 9781609186357.
- Polusny, M. A., Kehle, S. M., Nelson, N. W., Erbes, C. R., Arbisi, P. A., & Thuras, P. (2011). Longitudinal effects of mild traumatic brain injury and posttraumatic stress disorder comorbidity on postdeployment outcomes in national guard soldiers deployed to Iraq. Archives of general psychiatry, 68(1), 79-89.
- Shalev, A. Y. (2009). Posttraumatic stress disorder and stress-related disorders. Psychiatric Clinics of North America, 32(3), 687-704.
- Trauma-Informed Care in Behavioral Health Services (2014). Center for Substance Abuse Treatment (US). Rockville (MD): Substance Abuse and Mental Health Services Administration (US). (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/
- Children, Spouses of Military Members at Increased Risk for Mental Disorders. (2013). The Ranch. Retrieved 14 September 2017, from https://www.recoveryranch.com/articles/mental-health-articles/children-spouses-of-military-members-at-increased-risk-for-mental-disorders/
- Post-traumatic Stress Disorder (PTSD). (2017). Emedicinehealth.com. Retrieved 14 September 2017, from http://www.emedicinehealth.com/post-traumatic_stress_disorder_ptsd/page3_em.htm
- Veterans and Military Families | SAMHSA – Substance Abuse and Mental Health Services Administration. (2014). Samhsa.gov. Retrieved 14 September 2017, from https://www.samhsa.gov/veterans-military-families