War-Zone-Related Stress Reactions: What Families Need to
Know
Military personnel in war zones frequently have serious
reactions to their traumatic war experiences. Sometimes the
reactions continue after they return home. Ongoing reactions to
war-zone fear, horror, or helplessness are connected to
posttraumatic stress and can include:
Nightmares or difficulty sleeping
Unwanted distressing memories or thoughts
Anxiety and panic
Irritability and anger
Emotional numbing or loss of interest in activities or
people
Problem alcohol or drug use to cope with stress
reactions
How Traumatic Stress Reactions Can Affect Families
Family members are often impacted by these common stress reactions. Ways that family members are influenced can include:
Stress reactions may interfere with a
service member's ability to trust and be emotionally close to
others. As a result, families may feel emotionally cut off from
the service member.
A returning war veteran may feel
irritable and have difficulty communicating, which may make it
hard to get along with him or her.
A returning veteran may experience a loss of interest in family social activities.
Veterans with PTSD may lose interest in sex and feel distant from their spouses.
Traumatized war veterans often feel that something terrible may happen "out of the blue" and can become
preoccupied with trying to keep themselves and family members safe.
Just as war veterans are often afraid to
address what happened to them, family members are frequently
fearful of examining the traumatic events as well. Family
members may want to avoid talking about the trauma or related
problems. They may avoid talking because they want to spare the
survivor further pain or because they are afraid of his or her
reaction.
Family members may feel hurt, alienated, or discouraged because the veteran has not been able to
overcome the effects of the trauma. Family members may become angry or feel distant from the veteran.
The Important Role of Families in Recovery
The primary source of support for the returning soldier is
likely to be his or her family. Families can help the veteran not
withdraw from others. Families can provide companionship and a
sense of belonging, which can help counter the veteran's feeling
of separateness because of his or her experiences. Families can
provide practical and emotional support for coping with life
stressors.
If the veteran agrees, it is important for family members to
participate in treatment. It is also important to talk about how
the posttrauma stress is affecting the family and what the family
can do about it. Adult family members should also let their loved
ones know that they are willing to listen if the service member
would like to talk about war experiences. Family members should
talk with treatment providers about how they can help in the
recovery effort.
What Happens in Treatment for PTSD
Treatment for PTSD focuses on helping the trauma survivor
reduce fear and anxiety, gain control over traumatic stress
reactions, make sense of war experiences, and function better at
work and in the family. A standard course of treatment usually
includes:
Assessment and development of an individual treatment plan
Education of veterans and their families about posttraumatic stress and its effects
Training in relaxation methods, to help reduce physical arousal/tension
Practical instruction in skills for coping with anger, stress, and ongoing problems
Detailed discussion of feelings of anger or guilt, which are very common among survivors of war trauma
Detailed discussions to help change distressing beliefs about self and others (e.g., self-blame)
If appropriate, careful, repeated discussions of the trauma (exposure therapy) to help the
service member reduce the fear associated with trauma memories
Medication to reduce anxiety, depression, or insomnia
Group support from other veterans often felt to be the most valuable treatment experience
Mental health professionals in VA medical centers, community
clinics, and Readjustment Counseling Service Vet Centers have a
long tradition of working with family members of veterans with
PTSD. Couples counseling and educational classes for
families may be available. Family members can encourage the
survivor to seek education and counseling but should not try to
force their loved one to get help. Family members should consider
getting help for themselves, whether or not their loved one is
getting treatment.
Self-Care Suggestions for Families
Become educated about PTSD.
Take time to listen to all family members and show them that you care.
Spend time with other people. Coping is easier with support from others, including extended family,
friends, church groups, or other community groups.
Join or develop a support group.
Take care of yourself. Family members frequently devote themselves totally to those they care
for and, in the process, neglect their own needs. Pay attention
to yourself. Watch your diet and exercise, and get plenty
of rest. Take time to do things that feel good to you.
Try to maintain family routines, such as dinner together, church, or sports outings.
If needed, get professional help as early as possible, and get back in touch with treatment providers if
things worsen after treatment has ended.
References
Matsakis, A. (1996).
Vietnam wives: Facing the challenges of life with veterans
suffering posttraumatic stress. Baltimore, MD:
Sidran.
Mason, P. (1999).
Recovering from the war: A woman's guide to helping your
Vietnam vet, your family, and yourself. High Springs,
FL: Patience Press.
