This article provides an overview of the unique challenges combat service veterans deployed in Afghanistan and/or Iraq are dealing with today, and how these challenges can impact veterans’ reintegration into civilian life. Focus is also given to attachment; more specifically how the attachment bond between the combat service veteran and his or her spouse/partner often is impacted by the trauma of combat re-deployment/deployment/separation. The importance of couple counseling using Emotion-Focused Therapy (EFT) is addressed, as is a careful assessment at the onset of counseling.
American Psychiatric Association, (2000). Diagnostic and statistical manual of mental disorders, text revision (4th ed.). Washington, DC: Author.
2.
Arenofsky, J. ( 2008). Traumatic brain injury: An exploding problem. Retrieved from http://www.vfw.org
3.
Bartholomew, K., & Horowitz, I. ( 1991). Attachment styles among young adults. Journal of Personality and Social Psychology, 61, 226-244.
4.
Blake, D.D., Weathers, F.W., Nagy, L.M., Kaloupek, D.G., Gusman, F.D., Charney, D.S., & Keane, T.M. ( 1995). The development of a clinician-administered PTSD scale . Journal of Traumatic Stress, 8, 75-90.
5.
Bolby, J. ( 1988). A secure base: Parent-child attachment and healthy human development. New York, NY: Basic .
6.
Busby, D.M., Crane, D.R., Larson, J.H., & Christensen, C. (1995). A revision of the Dyadic Adjustment Scale for use with distressed and nondistressed couples: Construction hierarchy and multidimensional scales. Journal of Marital and Family Therapy, 21, 289-308.
7.
Castro, C.A., Hoge, C.W., Milliken, C.W., McGurk, D., Adler, A.B., Cox, A., & Bliese, P.D. ( 2006). Battlemind training: Transitioning home from combat. Silver Spring, MDWalter Reed Army Institute of Research . http://www.dtic.mil/ cgi-bin/GetTRDoc? AD=ADA481083& Location=U2&doc=GetTRDoc.pdf
8.
Channing Bete Company ( 2004). Military family wellbeing [Brochure]. SouthDeerfield, MA: Author.
9.
Coan, J.A., Schaefer, H.S., & Davidson, R.J. (2006). Lending a hand: Social regulation of the neural response to threat. Psychological Science, 17, 1032-1039.
10.
Cook, J.M., Riggs, D.S., Thompson, R., Coyne, J.C., & Sheikh, J.I. ( 2004). Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war. Journal of Family Psychology, 18, 36-45.
11.
Cornelius, J.R., Salloum, I.M., & Mezzich,J. ( 1995). Disproportionate suicidality in patients with comorbid major depression and alcoholism. Journal of Psychiatry, 152, 358-364.
12.
Crawley, J., & Grant, J. ( 2005). Emotion focused therapy for couples and attachment theory . ANZJFT, 26, 82-89.
13.
Dirkzwager, A.J., Bramen, I., Ader H., & van der Ploeg, H.M. (2008). Secondary traumatization in partners and parents of Dutch peacekeeping soldiers. Journal of Family Psychology, 19, 217-226.
14.
Evans, L., McHugh, T., Hopwood, M., & Watt, C. ( 2003), Chronic posttraumatic stress disorder and family functioning of Vietnam veterans and their partners. Australian and New Zealand Journal of Psychiatry, 37, 765-772.
15.
Foa, E.B., Riggs, D.S., Dancu, C.V., & Rothbaum, B.O. (1993). Reliability and validity of a brief instrument for assessing posttraumatic stress disorder. Journal of Traumatic Stress, 6, 459-473.
16.
Fontana, A., Rosenheck, R., & Brett, E. ( 1992). War zone traumas and posttraumatic stress disorder symptomatology . Journal of Nervous and Mental Disease, 180, 748-755.
17.
Gallup, G.G., & Maser, J.D.C. ( 1977). Tonic immobility: Evolutionary underpinnings of human catalepsy and catatonia. In M. E. P. Seligman & J. D. Maser (Eds.), Psychopathology: Experiential models (pp. 334-357). San Francisco, CA: W. H. Freeman.
18.
Holmes, J.G., Boon, S.D., & Adams, S. ( 1990). The relationship trust scale. Unpublished manuscript. University of Waterloo, Canada.
19.
Johnson, S. ( 2002). Emotionally focused couple therapy with trauma survivors: Strengthening attachment bonds. New York, NY: Guilford Press.
20.
Johnson, S.M., Makinen, C., & Milliken, J. ( 2001). Attachment injuries in couple relationships: A new perspective on impasses in couples therapy. Journal of Marital and Family Therapy, 27, 145-155.
21.
Joiner, T.E. ( 2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
22.
Jordan, K. ( 2004). The color-coded trauma genogram. Brief Treatment and Crisis Intervention, 4, 57-70.
23.
Jordan, K. ( 2006). The scripto-trauma genogram: An innovative technique for working with trauma survivors’ intrusive memories. Brief Treatment and Crisis Intervention, 6, 1-16.
24.
Kaplan, M. S., Huguet, N., McFarland, B. H., & Newsom, J. T. (2007). Suicide among male veterans: A prospective population-based study. Journal of Epidemiological Community Health, 61, 619-624.
25.
Kessler, R.C. ( 2000). Posttraumatic stress disorder: The burden to the individual and to society. Journal of Clinical Psychiatry, 61, 4-12.
26.
King, D.W., King, L.A., Gudanowski, D.M., & Vreven, D.L. ( 1995). Alternative representations of war zone stressors: Relationships to posttraumatic stress disorder in male and female Vietnam veterans. Journal of Abnormal Psychology, 104, 184-196.
27.
Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R., & Weiss, D.S. ( 1990). Trauma and the Vietnam war generation: Report of findings from the National Vietnam Veterans Readjustment Study. Philadelphia, PA: Brunner/ Mazel.
28.
Lorge, E. ( 2008). Army responds to rising suicide rates. http://www.army.mil/-news
29.
Mansfield, A., Kaufman, J.S., Marshall, S.W., Gaynes, B.N., Morrissey, J.P., & Engel, C.C. ( 2010). Deployment and the use of mental health services among U.S. army wives. New England Journal of Medicine, 302, 101-109.
30.
Matsakis, A. ( 2007). Back from the front: Combat trauma, love and the family . Baltimore, MO: Sidren Institute Press.
31.
McFarland, A.C., & van der Kolk, B.A. (1996). Trauma and its challenge to society. I. B. van der Kolk, A. McFarlane, & L. Weisaeth (Eds.), Traumatic stress (pp. 24-46). New York, NY: Guilford Press.
32.
Mills, B., & Turnbull, G. ( 2001). After trauma: Why assessment of intimacy should be an integral part of medico-legal reports. Sexual and Relationship Therapy, 16, 299-308.
33.
Nelson Groff, B.S., Crow, J.R., Reisbig, A.M.J., & Hamilton, S. ( 2007). The impact of individual trauma symptoms of deployed soldiers on relationship satisfaction. Journal of Family Psychology , 21, 344-353.
34.
Oquendo, M., Brent, D.A., & Birmaher, B., (2005). Posttraumatic stress disorder comorbid with major depression: Factors mediating the association with suicidal behavior. American Journal of Psychiatry, 162, 560-566.
35.
Panksepp, J. ( 2005). On the neuro-evolutionary nature of social pain, support, and empathy. In J. Panksepp (Ed.), Pain: New essays on its nature and the methodology of its study (pp. 367-387). Cambridge, MA: The MIT Press.
36.
PTSD Support Services (n.d.). The struggle to care for wounded GI’s. Retrieved from http://www.ptsdsupport.net
37.
Riggs, D.S., Byrne, C.A., Weather, F.W., & Litz, B.T. ( 1998). The quality of the intimate relationships of male Vietnam veterans: Problems associated with posttraumatic stress disorder. Journal of Traumatic Stress, 11, 87-101.
38.
Rothchild, B. ( 2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York, NY: W. W. Norton.
39.
Rugger, W., Wilson, S.E., & Waddoups, S.L. (2002). Warfare and welfare: Military service, combat, and metital dissolution. Armed Forces and Society, 29, 85-107.
40.
Sherman, M.D., Zanotti, D.K., & Jones, D.E. ( 2002). Key elements in couple therapy with veterans with combat-related posttraumatic stress disorder. Professional Psychology: Research and Practice, 36, 626-633.
41.
Simon, C.C. ( 2007). Bringing the war home. Psychotherapy Networker, January/February 28-37.
42.
Solomon, Z., Waysman, M.M., Levy, G., Fried, B., Mikulincer, M., Benbenishty, R., Florian, V., & Bleich, A. ( 1992). From front line to home front: A study of temporary traumatization . Family Process, 31, 289-302.
43.
Tanielan, T., & Jaycox, L. ( 2008). Invisible wounds of the war. Table4.4, p.97. Santa Monica, CA: RAND Corporation.
44.
U.S. Department of Defense, Statistical Information Analysis Division (2010). Armed Forces Strength Figures for November 30, 2010. Retrieved from http://siadapp.dmdc.osd.mil
45.
Weathers, F., Litz, B., Herman, D., Huska, J., & Keane, T. ( 1993). PTSD Checklist (PCL). Retrieved from U.S. Department of Veterans Affairs website: http://www.ptsd.va.gov
46.
Zivin, K., Kim, M., McCarthy, J.F., Austin, K.L., Hoggatt, K.J., Walters, H., & Valenstein, M. (2007). Suicide mortality among individuals receiving treatment for depression in the veteran’s affair health system: Association with patients and treatment setting characteristics . American Journal of Public Health, 97, 2193-2198.
47.
Zoroya, G.Army wives with deployed husbands suffer higher mental health issues ( 2010, January 13). USA Today. Retrieved from www.usatoday.com
