Post Deployment on Family Life

It is stated in a Defense Watch document entitled “Post-Deployment Stressful for Many Veterans” that deployments are not only stressful for members of the armed forces but as well deployments are “also very stressful on the families who’ve had to create a daily routine without their deployed soldier.” (Defense Watch, 2010) The spouse of the individual deployed naturally must take on many more responsibilities in the home including those related to “…finances, household repairs, disciplining of children, and other day-to-day activities.” The result is that many spouses are overwhelmed by responsibility and this produces a great deal of “anxiety, stress, and occasionally, substance abuse.” (Defense Watch, 2010) In contrast, the impact is quite the opposite with the spouse left behind thriving on the extra responsibility and at the time the deployed spouse returns home, the spouse who was left with all the responsibilities at home has a difficult time relinquishing those to the returned soldier. (Defense Watch, 2010, paraphrased)

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The Defense Watch document additionally relates that upon the soldier returning home “reunions can often be awkward and tense s everyone adjusts to the changed family dynamics.” (Defense Watch, 2010) When the family member who has been deployed has been gone for a period such as twelve months and then is suddenly home 24 hours a day, 7 days a week, the stress potential is very high. Defense Watch reports that family members of deployed veterans are encouraged upon the veteran’s return to attend classes that are provided by the Family Support Group for each military unit which is focused on preparing family members for the adjustments that will be required upon the soldier’s return from deployment. The adjustment is differentiated for those who serve as National Guard and Reserve soldiers and as well single soldiers also have their own adjustment challenges. (Defense Watch, 2010)

Also noted in the Defense Watch document is the strain that the 24-hour news cycle places on soldiers and their family members and this includes during and following deployment. This is because following deployment the impact of the returned soldier hearing news and seeing images of war have a hard time putting their active duty behind them. Director of one unit Family Support Group, stated as follows:

“Family members seeing events unfold are often worried that their loved one could be involved in the latest set of attacks. With instant e-mail and cell phones, soldiers and their families can be in constant communication, which can lead to additional stress and expectations…most of the symptoms of combat stress that soldiers experience are emotional responses, but nearly everyone interviewed shared the same physical response to loud noises.” (Defense Watch, 2010 )

One service member recalls: “We missed getting blown up a couple of times, so when I hear a loud noise I jump,” said Sharpe, explaining that his compound in the Green Zone was bombed regularly. “We had one [mortar round] that landed right outside our area, the building shook and all the windows broke…” (Defense Watch, 2010) The individual was speaking of his term in active duty in Baghdad and he additionally states that he believed that he was “doing okay…until the Fourth of July. “I couldn’t listen to the fireworks,” (Defense Watch, 2010) The service member reports that he was forced to leave the festivities.

Five Stages of Deployment

The work entitled “The Emotional Cycle of Deployment: A Military Perspective “reports that military families “…have experienced the emotional trauma of deployment on an unprecedented scale since the end of the Gulf War.” (Military Advantage, 2010 ) Different strategies for coping are required as there are reported to be “five stages of deployment.” (Military Advantage, 2010) It is stated to be necessary to train health care providers and military leaders to assist family members through each of these five stages of deployment. (Military Advantage, 2010, paraphrased) The study reported is one that is stated to be reliant on the narratives of families and service members. The five stages of deployment are stated to include those as follows:

The Five Stages of Deployment

1. Pre-deployment — varies, from several weeks to more than a year.

2. Deployment – 1st month – the period from the Soldier’s departure from home through the first month of the deployment.

3. Sustainment – months 2 through 5

4. Re-deployment – last month

5. Post-deployment – 3-6 months after deployment (Military Advantage, 2010)

Each stage is characterized by a “time frame and specific emotional challenges” that have a requirement of being addressed and then “mastered by each of the Family members.” (Military Advantage, 2010) When these challenges are not addressed the result is “significant strife — both for Family members and the deployed Soldier.”( Military Advantage, 2010) Making the provision of information concerning what the individuals should anticipate and especially in cases where the families have no experience with lengthy separations is a very effective method of bringing about a sense of normalcy and enabling the family members to positively cope with the experience of deployment. (Military Advantage, 2010, paraphrased) In addition, the promotion of the comprehension of the various challenges associated with each stage of deployment is an effective method of avoiding crises and well as bringing about a minimization in the need for “command intervention or mental health counseling and can even reduce suicidal threats.” (Military Advantage, 2010 ) Each of the stages are described as follows:

Stage One: Predeployment: The onset of this stage begins with the warning order for deployment. This stage ends when the Soldier actually departs from home station. The pre-deployment timeframe is extremely variable from several weeks to more than a year. (Military Advantage, 2010) It is reported that emotional distance is one of the primary complaints of family members during pre-deployment and as well many questions remain in regards to the stages of deployment following that of pre-deployment. (Military Advantage, 2010)

Anticipation of loss vs. denial

Train-up/long hours away

Getting affairs in order

Mental/physical distance

Arguments

Time frame: variable (Military Advantage, 2010)

Stage 2: Deployment

This stage is the period from the Soldier’s departure from home through the first month of the deployment. (Military Advantage, 2010)

Mixed emotions/relief

Disoriented/overwhelmed

Numb, sad, alone

Sleep difficulty

Security issues

Time frame: first month (Military Advantage, 2010)

Stage 3: Sustainment: The sustainment stage lasts from the first month through the fifth (penultimate) month of deployment. (Military Advantage, 2010)

New routines established

New sources of support

Feel more in control

Independence

Confidence (“I can do this”)

Time frame: months two thru five (Military Advantage, 2010)

Stage 4: Re-deployment: The re-deployment stage is essentially defined as the month before the Soldier is scheduled to return home. (Military Advantage, 2010)

Anticipation of homecoming

Excitement

Apprehension

Burst of energy/”nesting”

Difficulty making decisions

Time frame: months five thru six (Military Advantage, 2010)

Stage 5. Post-deployment

Honeymoon period

Loss of independence

Need for “own” space

Renegotiating routines

Reintegrating into Family

Time frame: three to six months after deployment (Military Advantage, 2010)

The Defense Watch report states that many challenges exists for military families in overcoming the five stages of deployment. Anticipation of the challenges is critical to minimizing the potential emotional trauma of extended deployment. The following chart lists the pitfalls and helpful hints for deployment.

Figure

Pitfalls and Helpful Hints for Deployment

Pitfalls Helpful Hints

Over-interpreting arguments Establish a base of support

Hot topics/long distances Make plans to break up time

Rumors/loss of trust E-mail, phone calls, letters

Investment in date of return Avoid overspending/alcohol

Not accepting changes in marriage Single parents need time without kids.

The work of Karney, et al. (2008) entitled “Invisible Wounds” states that the effects “of post-combat mental disorders inevitably extend beyond the afflicted service member. As service members go through life, their impairments cannot fail to impact those they interact with, and those closest to the service member are likely to be the most severely affected.” ) It is stated that there is a wide range of empirical literature documenting the range of negative consequences that post-combat mental disorders have had on the families of service members returning from prior conflicts. In general, research on the consequences of mental disorders for families has identified direct and indirect routes through which these consequences come about.” (Karney, et al., 2008)

The family members and other loved ones are impacted by the problems hat returning service members have with “emotion regulation, predicting greater risk of physical violence in the home” all of which are direct impacts. Included in the direct impacts is “the inability to sustain employment.” (Karney, et al., 2008) Each of these impacts has been directly linked to “difficulties maintaining intimate relationships” and as well each of these disorders has been accredited for “increased risk of distressed relationships, intimate partner violence, and divorce among those afflicted.” (Karney, et al., 2008) Additionally, it is reported that “…interpersonal deficits that interfere with emotional intimacy in the romantic relationships of service members with these disorders appear likely to interfere with their interactions with their children as well. Thus, the impact of post-combat mental disorders may extend beyond the lifespan of the afflicted service member to stretch across generations. (Karney, et al., 2008)

Karney et al. (2008) makes recommendations for future research including the following areas:

(10 Address causal relationships. The model proposed here suggests that the experience of a post-combat mental disorder is a cause of negative outcomes for service members, in that they account for the experience of negative outcomes that the service member would not have experienced in the absence of the disorder. The research reviewed in this report is consistent with this position, but the vast majority has not been capable of ruling out alternative interpretations. Most of this research has relied on cross-sectional and retrospective designs, i.e., research participants have been contacted on a single occasion and asked to report on their experience of psychiatric symptoms and their functioning in other life domains. Supporting causal statements about the impact of mental illness will at minimum require longitudinal research, i.e., studies that assess individuals on multiple occasions to determine the temporal ordering of symptoms and outcomes. Longitudinal research that successfully follows service members from pre-deployment, through post-deployment, and into post-service would provide crucial insights into the etiology and consequences of combat-related mental illness. In the absence of such data, the existing research supports conclusions about how mental disorders are associated with subsequent negative outcomes for service members, but not about whether the disorders may be considered causes of those outcomes.”

(2) Assessment and diagnosis. Although research on the prevalence of PTSD, depression, and TBI after service in OEF and OIF has relied on only a small number of assessment tools, research on the consequences of these disorders has used a vast array of instruments and strategies. Some research has examined associations between each disorder and outcomes shortly after combat, whereas other research, especially research on veterans of Vietnam, have examined these associations years or even decades after the veterans had their combat experiences. Understanding how mental disorders affect the lives of afflicted service members will require greater attention to how and when these disorders are assessed.

(3) Generalizing across services and components. Research on the implications of mental disorders in veterans of Vietnam rarely specifies the component of the military (i.e., active duty or Reserves) or the service within which the veteran served. Because different segments of the military are likely to have different experiences and have access to different sources of support, careful attention to service and component will be important in future research to understand the mental health implications of OEF and OIF. To inform the future allocation of resources between Reservists and active duty members, research that directly compares the prevalence and consequences of mental disorders across the services and across the components is needed.

(4) Gathering population data. Virtually all of the data on the implications of post-combat mental disorders come from treatment, clinical, and help-seeking samples. Because those who seek treatment are likely to differ from those who do not, these samples form an inadequate basis from which to draw conclusions about the military as a whole. Systematic assessments of the entire military population will provide a more accurate sense of the distribution of post-combat mental disorders and their consequences, and thus a more accurate view of the true costs of the current conflicts.” (Karney, et al., 2008)

Recommendations stated by Karney et al. (2008) for policy and intervention include the following:

(1) Facilitate service members seeking and receiving treatment.

(2) Early interventions are likely to pay long-term dividends.

(3) Policies that promote resilience may be as effective as programs that target the symptoms of mental disorders directly. (Karney, et al., 2008)

The work of Finley, Pugh, and Jeffreys (2010) entitled “Talking, Love, Time: Two Case Studies of Post-Deployment Coping in Military Families states that the question of how “… how individuals engage in coping has gained increasing notice over the past decade.” The study reported by Finley, Pugh and Jeffreys (2010) is of the nature that conducts an in-depth study of two couples who have experienced extended deployment. The post=deployment challenges of: (1) Derek and Laticia; and (2) Josh and Laurie are examined. Derek is a disabled veteran and college students who was a communications specialist in the Army before he was wounded in Iraq resulting in his leg being amputated and in him receiving an early discharge. Derek and his wife are African-American and have two sons, by Laticia’s previous marriage. Josh is a former marine who was wounded in Iraq and suffered a traumatic brain injury. He is also attending college. Josh and Laurie’s son is an infant. Josh and Laurie are both Euro-American. The amount of communication between family members was stated to vary during the deployments of both Josh and Derek and there was very little communication through email or telephone. Laticia dealt with Derek’s deployment through taking a heavy coarse load and Derek was going out on patrol each day with Laticia watching the kids and studying for her tests. Derek had not been honest with Laticia about his assignment and she was shocked when she got the call that his leg had been amputated. It is reported that Josh:

“… articulated the challenge of reconciling such a chasm of unshared experiences when he said of his post-deployment relationship with Laurie that, “It’s hard to live with another person again after a [deployment], because you’ve had six months of different experiences. After being away for so long, each person has their own expectations of what the other is going to be like.” (Finley, Pugh, and Jeffreys, 2010)

There is noted in the study that while Josh found everything at home somewhat recognizable, for Laurie, the alterations in Josh were “dramatic enough to reshape their relationship entirely. It is common for family members to find their service member has been changed by his or her experience of deployment. Laurie said that after the first of two deployments, Josh was, “Just different.” (Finley, Pugh, and Jeffreys, 2010 ) The different noted that rather than being the one who wanted to get things done that Josh just wanted to sleep when he got home. According to Laurie the couple almost switched roles. This is not unusual according to Finley, Pugh, and Jeffreys who states that “…both the personal changes wrought by combat deployment and the necessity for family members of functioning without the service member can create a situation in which it is necessary to reconsider pre-deployment patterns of behavior and responsibility. Prior to his first deployment, it had been Josh’s role to calm Laurie down when she became anxious over worries or household tasks. Now they reversed roles. They found themselves, as Josh described, in a period of “getting to know each other again,” sorting through each partner’s “expectations of what the other is going to be like.” (Finley, Pugh, and Jeffreys, 2010 ) Finley, Pugh, and Jeffreys relate that Derek spent four months living in an outpatient house on base. Derek states that Laticia’s biggest complaint was that “…for a long time I was extra clingy. I wanted her by my side at all times. I had missed her for eight months. I had gone through being blown up three times in one day, any day can be the last one. So I was already mentally trying to figure out that I might never see her again. And then being in an explosion and getting injured myself, and seeing that I was still here and feeling like it was on borrowed time…and it drove her nuts.” (Finley, Pugh, and Jeffreys, 2010 ) Laticia states that Derek was very clingy and this coming from a man who had formerly been independent and self-sufficient was hard to adjust to for Laticia.

When Josh was redeployed he got caught in an explosion and sustained a significant Traumatic Brain Injury (TB) and the consequences have included the following:

“Long-term memory is dicey. Speech is dicey. There are times, especially if I get emotional, that I have to search for words. I hesitate. I stumble. Hearing’s screwed up. I can technically hear perfectly, but there’s something where it gets jumbled in my brain and I can’t figure it out, or I just don’t hear it. Other problems like balance.” He is unable to drive at night because he has a hard time judging distances and lacks concentration. He cannot pay bills because he forgets them. He says, with some bitterness, “The most I can do is to play with my son, and that’s about it.” (Finley, Pugh, and Jeffreys, 2010)

The outcome is that Laurie is saddled with the responsibilities that Josh cannot fulfill and this is in addition to “overseeing his frequent medical appointments and the paperwork associated with his veterans’ disability claims, trying to supplement his disability compensation with a part-time job, watching out for him – with his impaired balance, everything from taking a shower to walking down stairs requires supervision – and caring for their infant son. (She says she is unable to get enough sleep, is “very stressed,” and gets “frustrated very easily.” The worst, she says, is that Josh has lost much of his expressiveness due to his injury. “With him I never know if he’s angry or happy. His facial expressions, his tone of voice – it’s very difficult for me to tell the difference.” (Finley, Pugh, and Jeffreys, 2010)

References

Post-Deployment Stressful for Many Veterans (2006) Defense Watch. Military.com Soldiers for the Truth (SFTT) 20 Feb. Retrieved from: http://ptsdcombat.blogspot.com/2006/02/defensewatch-post-deployment-stressful.html

Karney, Benjamin, et al. (2008) Invisible Wounds: RAND Health Working Paper. Center for Military Health Policy Research. Retrieved from: http://www.litagion.org/pubs/working_papers/2008/RAND_WR546.sum.pdf

Network of Care for Service Members, Veterans & Their Families (2010) Retrieved from:http://montgomery.md.networkofcare.org/veterans/library/detail.cfm?id=2113&cat=443

Finley, E., Pugh, M.J.; and Jeffreys, M. (2010) Talking, Love, Time: Two Case Studies of Positive Post-Deployment Coping in Military Families. Family Life Journal. 20 Jan 2010. Retrieved from: http://www.journaloffamilylife.org/militaryfamilies

Gregg Zoroya (2008) “Divorce Rates Rise for Soldiers, Marines,” Army Times 2008.

Regina Yiven, Eva Bjorck-Akesson, and Mats Granlund, (2006) “Literature Review of Positive Functioning in Families with Children with a Disability,” Journal of Policy and Practice in Intellectual Disabilities 3, no. 4 (2006).