JS: You mentioned before something that is very important: the matter of relationships, and the importance of choosing carefully which friends you can rely on. However, those veterans who are married or have partners don’t really have that choice, and neither do their family members, who often suffer as a result of the psychological pain their loved ones are living with. What do they need to know about PTSD and trauma? What can they do to help a husband, a wife or a partner—or a son or daughter—who has come back from war with invisible wounds?

FO: You know, they can read articles like this. They can become, if not experts, very well informed about PTSD. I think if you are a loved one of someone with PTSD, you want to be the smartest person on your block when it comes to understanding PTSD – and it’s easy to understand. I actually wrote an article for the partner, and it’s been well-received on the Web. It gets a lot of hits.

But you don’t need to stick with what Frank Ochberg has to say about the subject. Learn about it; learn just what the definition is; and learn that your role as a partner can be a very helpful role. But you shouldn’t be presumptuous; you shouldn’t presume that you know what’s best for a loved one with PTSD. Ask around. Talk to other spouses of people with PTSD. Ask your partner how you can be helpful. Some partners do want you to be there as a sounding board. Others don’t really want you to ask too many questions.

Now, I have wives of men with PTSD and husbands of women with PTSD, and I really appreciate it when they say they want an appointment with me. Of course, I have to ask my patient if it’s all right, and sometimes they say it’s not all right. But usually they agree. Then we have a discussion. I don’t have to give away private information. The discussion is a tutorial on PTSD, and listening to the specific things that come up in that discussion.

It’s very frustrating to be the loved one of someone who has PTSD. I mean, by definition it means your partner doesn’t have a full range of feeling. I’ve had people with PTSD say, “I know I love my wife. I just don’t feel it the way I should.” Now, that’s a hard message for a wife to hear, and there’s a better message: the message that “I know I love you, and I don’t feel it the way I know I should.” That’s a much better message than “I don’t love you.”

JS: It sounds cliché, but an observation that is commonly made about veterans is that they tend not to talk much with their families about some of their more disturbing war-time experiences, and you alluded to this earlier in the conversation. How important is it for soldiers to share what they went through, what they saw in combat?

FO: I don’t know how important it is. I think it’s important for many soldiers who have gone through something terrible to be able to protect their loved ones from the images, the memories that they have. By now I must know hundreds of men who have PTSD, and they take a certain amount of pride from protecting others from the full force of what they went through.

Of course, when you look at this logically, their wives, sons, daughters, fathers, they read the newspapers, they watch television, they go to the movies. We are a generation that has seen this sort of stuff, so family members can put two-and-two together. But still, there’s a certain amount of protective feeling that soldiers, marines, others have—that they don’t want to spill that stuff onto people that they love.

Now in certain circumstances, they will. In some circumstances veterans will talk to those close to them about their experience of war, but there is a way that war stories are told. The way war stories are told by veterans to their family is not the same thing as them talking to a psychiatrist or a psychologist about a very poignant and distressing experience.

Let me give you an example. I asked one of my marine patients, I’ll call him Jim: “Do people understand what you’re telling me?” Jim said, “No, no. They don’t.” And I said: “Well, who understands?” He had to think for awhile and said: “There was this guy who was in the hospital bed next to me. He was in combat and his leg was shattered. Another marine came up to help him, to rescue him, and this marine got shot in the neck.”

I don’t know the name of the marine whose leg was shattered. I just know him as the marine from Terra Haute, in Indiana. So, the guy from Terra Haute was trying to stop the bleeding and comfort his fellow marine, who died. And the guy from Terra Haute believed that he caused the other marine’s death by allowing himself to get shot in the leg and needing to be rescued. Well, in a way, he did.

My patient, Jim, the marine who was telling me this story, had a similar experience. And I think every combat marine who lives through something like this lives with a sense of guilt because other marines died. But the point is, when Jim talks to me about his experience that’s not the same way he’s going to talk to someone else when he tells a war story.

Photo credit: John Moore, Ochberg Fellow

Marines don’t tell war stories the way they tell their stories to psychiatrists, and I don’t think they tell their stories the same way to every psychiatrist. I hear about other psychiatrists who are held in contempt by these marines because they asked for details before they had earned the marines’ respect.

I think war reporters understand what we are talking about here—it’s the difference between people swapping stories and then people telling you what’s really close to their hearts. That’s what I’m talking about: the difference between recounting a combat story, and telling it with…well, I don’t want to say with tears in your eyes, but you know what I mean.

JS: I think I do. Several years ago in Washington DC I met an Army veteran who had served in Iraq, and while he was talking about what he’d experienced there he broke down, started sobbing, and collapsed in my arms. Although I hadn’t served in Iraq in a military role and hadn’t had the sort of traumatic combat experience this veteran had had, I’d spent a fair amount of time there—including time with the US military—and could relate to a lot of what he was telling me. I’m not entirely sure what led him to talk about the things that led him to break down, but I guess he might not have felt able to get to the point where those emotions came out if he’d been speaking with someone he felt didn’t have some understanding of what he’d been through.

FO: Did you think that he was getting something healthy from having the opportunity to reach so deep and tell you his story?

JS: I really don’t know. This young guy was dealing with a lot of trauma, including the death of a comrade who’d been killed next to him on patrol. It seemed to me that once he started talking about some of these things he just couldn’t keep all that pain inside; but whether or not it helped him to talk about his experiences is hard to say. Fortunately, when he broke down, one of his buddies came over and took care of him and led him away. I say “fortunately” because I was far from sure what to do or say. Frankly, I’m not sure there’s anything one can say in those situations.

FO: You know, I need to figure out what journalists can say in those situations. I’m in a position now, as a psychiatrist who talks with journalists, where I’m helping to create a network of journalists who have learned through trial and error what seems to work.

 

APA Reference
Jon Stephenson. (2011). Veterans and Post-Traumatic Stress Disorder: A Conversation with Dr. Frank Ochberg. Psych Central. Retrieved on December 19, 2014, from http://psychcentral.com/lib/veterans-and-post-traumatic-stress-disorder-a-conversation-with-dr-frank-ochberg/0006135
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    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
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