Running Head: POST-TRAUMATIC STRESS DISORDER

Post-Traumatic Stress Disorder

Gabriela Alvara
University of Texas at El Paso

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Abstract
Ever since 1861, Post-Traumatic Stress Disorder has gone through a variety of different
names and meanings. Even today, combat veterans and active soldiers feel shame for having
PTSD on their record because to others it means lack of guts to fight in the war. But, to combat
veterans and active soldiers it has so much more meaning than that. They struggle with it on a
daily basis and it does not only affect them as individuals but also their families and children.
Unfortunately, even after they go through all the main symptoms like anger and violence it
causes families to fall apart. Luckily, various treatments like Prolonged Exposure Therapy exists
to help active soldiers and combat veterans deal with their symptoms. Sometimes therapy can be
so successful that active soldiers consider returning to the field of combat and fight for their
country again. Even though this action could have its pros and cons, it is possible for an active
soldier to return to war and apply the skills they mastered in therapy.

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Post-traumatic stress disorder: A Review of Literature

Early in the years, Post-traumatic stress disorder (PTSD) was not taken seriously; soldiers
did not believe it could be an actual disorder. Some soldiers were humiliated by others because
of PTSD; they thought they were just unfit for the war. Since the Civil War, the name and
meaning of PTSD has been changed. Today, Post-traumatic stress disorder is when an individual
like a soldier go through a traumatic experience that made them feel afraid and out of control
from something that is happening. After a soldier comes back home from war, they experience
stress related reactions that interferes with their daily routines as if they are always in danger.
PTSD does not only affect the person that is going through it but also their families, sometimes it
even breaks families apart. Even after a soldier goes through treatment and succeeds well, they
can go back to the war zone where their PTSD began. Taking into consideration this information,
three questions will be discussed:
1.) How does Post-Traumatic Stress Disorder have an impact on families and combat
veterans?
2.) How can communication between combat veterans and their spouse influence PostTraumatic Stress Disorder?
3.) After men who come back from combat receive treatment, what are the risks of going to
back to serve the country?
The review of literature on PTSD will provide information on impacts of the disorder on
families and combat veterans and how it can break them. Also, it will discuss the possibilities
of returning back to combat after succeeding PTSD treatment.

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How does Post-Traumatic Stress Disorder have an impact on families and combat
veterans?
PTSD does not only have a big impact on combat veterans but also on their families
emotionally and physically. According to COL. John Bradley, Chief of Psychiatry at Walter
Reed Medical Center in Washington D.C., "...as soldiers say Im just jacked up, Im ready for a
fight, Im ready to save somebodys life, Im ready to come back at the enemy, and the problem
with PTSD is those symptoms dont go away when we come back home." (2010, 8:00) Families
and combat veterans have to deal with this change and adjustment when they come back home.
According to a combat veteran and counselor for twenty years Jim Dooley, in the video The
Soldiers Heart he states when combat veterans return home they being to struggle with what
they experienced, what they had to do as part of their job, and what they did not do. (2005, 5:46)
Combat veterans have a hard time adjusting from war zones to society and this leads to
detachment from families. Combat veterans from World War II felt as if they could not talk to
their families about having PTSD because they felt it was not a good thing to talk about the war.
A World War II veteran in the video, Warton 1861-2010 says, "how could I tell my grandson he
is not coming back the same person that left, I wasnt the same person that left." (2010, 25:54)
When a family member comes back from war, their family notices quickly that they are not the
same person anymore. Families have to deal with nightmares, crimes, suicidal thoughts,
violence, and alcohol abuse.
A case in the video shows how a
mothers son who served time in Iraq in the
Marine Corps committed a crime as he had a
danger or threat flashback. As shown in Figure

Figure 1

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one (2010, 45:32) her son, Nathan Damigo has been given the court sentencing of six years in
state prison, the mother comments, "...Its like they put him through a paper shredder, they took
him when he was eighteen put him through a paper shredder and then send it back to us and we
have try to put the pieces together." (2010, 47:45) Children even experience distance from their
family members as well. They feel as their family members will not interact with them the same.
In every environment, a combat veteran feels everything as a threat that, they have to keep an
eye on everything around them. According to the authors, Daryl S. Paulson and Stanley Kippner,
Haunted by Combat, Matt says," I am pissed and have seen too much killing. I had to go to
counseling for my anger." (2010, p.45) As a combat soldier or veteran, PTSD does not only
affect them individually but also their families.
How can communication between combat veterans and their spouse influence PostTraumatic Stress Disorder?
Communication is known to be a key to a successful marriage, but when a combat soldier
or veteran goes through PTSD, communication becomes difficult to maintain with their spouse.
In the video Wartorn 1861-2010, combat veteran PVT. Michael Shields from the United States
Army said, I never talked to my own wife about the war, I didnt think it was a good thing to
bring up. (19:57) After going through a traumatic experience in the war, combat veterans have
felt the inability to be able to talk to their spouses about the war. One of the many reasons was
because they felt ashamed of what they had to do in the war that was considered their job and
also felt fear of losing the support had from their wives. While this tends to happen they also
begin to distance themselves from their spouses and their children because the combat veteran or
active soldier may feel they cannot be there for their spouse. In the book Haunted by Combat by
Daryl S. Paulson and Stanley Krippner, combat veteran Rich explained, I loved her, but I was

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not availableMy wife needed me, but I just could not give her [the emotional sharing] that she
wanted. (2010, p.45) One of the main symptoms in PTSD is anger and violence and a lot of the
spouses go through this with their significant other. Their spouse may be going through bursts of
anger and it can cause violence for example punching the walls in their home. The National
Council on Disability say, In other situations, the veteran with PTSD may have a sharp temper
or violent streak that scares or angers the spouse. (2009). While the combat veteran or active
soldier may be experiencing anger and violence, it affects their spouses in a variety of ways.
Their spouse may feel scared and unsafe just by being around their significant other. In the video
Wartorn 1861-2010, a combat veterans wife Marie, describes the way she feels when her
husband is going through bursts of anger and violence, I was petrified, Ive never been that
scared of him before in my life, so my first instinct was to leaveit was hard for me to trust him
again, to feel safe with him again. (2010, 59:10)
Most of the time what these combat veterans or active soldiers feel is anxiety, depression,
and guilt. The reason for this is because they feel they could have done something to prevent
what they had to do as part of their job. Vietnam veterans said they could not talk to their wives
about the war because it was a subject not to talk about during that time. According to Mary
Webb-Tafoya, It is recommended that veterans, active or not, do NOT discuss their experiences
with family for many reasons1) If family members or spouses knew personal accounts of their
service members actions or experiences, they are more inclined to change their views about or
towards them and this is the service members' biggest fear. Would the hero still be a hero if the
family knew the degradation, humiliation, terror, or necessary actions the warrior had to take to
survive? (Personal Communication, 2014)

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Vietnam veterans explain how having PTSD was an embarrassment, this lead to
difficulty talking to their spouses about it. During the time of the Vietnam War, PTSD was not
recognized very well and if it was, the combat soldier was known to not have enough guts to
fight the war. Combat veteran from the United States Army Air Corps, LT. Al Maher mentions
in the video how back in the day it was not good to have PTSD in your record, Lack of
intestinal fortitude, they would put it in your record, and nobody would want that; you didnt
want that on their, that was the worst thing. (2010, 19:36) Some veterans explained how they
could not find the correct words to even describe what they had gone through during the war,
which explains the second reason to why veterans or active soldiers are recommended to not talk
about their experiences to their spouses. If the spouses ever decided to go through treatment
which consists of stages to be able to cope and support the combat veteran or active soldier, the
process could take up to one to five years which can be emotionally draining. (Webb-Tafoya,
Personal Communication, 2014)
As soon as a combat veteran or combat soldier comes back from deployment, PTSD
symptoms may not show right away, according to Mary Webb-Tafoya it takes about six to
twelve months for the symptoms to show. Even after the symptoms show some combat veterans
and active soldiers may just think they are going through difficulties adjusting from a war zone
to civilian life which leads them to not look for help for months or even years. (Personal
Communication, 2014) After recognizing the possibility of them having PTSD, they think if they
do not think about their flashback and nightmares it will go away with time. (Paulson, S. Daryl &
Kirppner, Stanley, 2010, pg. 48) Mary Webb-Tafoya mentions, when a combat veteran or active
soldier believe the difficulties of Post-Traumatic Stress disorder will go away with time, it can
lower the success rate of successfully completing treatment. If they begin going to treatment and

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are not given any ways to cope with their symptoms or remembering the traumatic experience
while going through the process of treatment can lead the individual to give up or relapse.
(Personal Communication, 2014) Even though time may not be the answer, treatment could be if
they are acceptable of all challenges and issues. Some go through treatment successfully and
even consider going back to serve their country.
After men who come back from combat receive treatment, what are the risks of going back
to serve the country?
After men who have succeeded in PTSD treatment, going back to serving the country
exposes them for high risks in the future but also depends on the individual. During the time that
men decide to be deployed again, the risk of them going through a traumatic experience is high.
After they experience the trauma, some symptoms of PTSD which are already present, have a
high risk of increasing. According to PTSD Research Quarterly, Probable PTSD prevalence for
active duty soldiers increased from 11.8% to 16.7%. (2009, p. 2) When a combat soldier
decides to go back to the war zone, not only do they increase the risks that affect themselves but
also others. Having PTSD can prevent the ability for the individual to work with others and
concentrate on tasks given by superiors. According to Mary Webb-Tafoya, If a Soldier is not
properly assessed prior to treatment, during treatment and post treatment, to evaluate progress or
lack of, there will be no way to know if they are equipped to function on the job. (Personal
Communication, 2014) Since Post-Traumatic stress disorder can affect others in the work
environment, it is important for an individual who has PTSD to be assessed in order to see if they
are able to go back to combat and be able to do their jobs with no other distractions. Smells,
sights, and sounds can cause these combat soldiers with PTSD to remember traumatic events and
become isolated.

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Even though they may go through successful therapy, going back to combat may access
them to experience new trauma they never have experienced before. There is a possibility that
the trauma may cause their symptoms such as violence and stress to increase in a manner they
have not learned to deal with. (Wangelin C. Bethany & Tuerk W. Peter, 2014, pg. 164) Although
there is not data to prove that combat soldiers have gone through successful prolonged exposure
therapy to work in the long run when they go through combat all over again, there is a possibility
for it. Mary Webb-Tafoya says, Therefore, with that being said; can some Soldiers go through
treatment and return back to active duty status? The answer is yes. (Personal Communication,
2014)
Another risk a combat soldier may take when going back to combat after receiving
successful treatment for PTSD, would be expecting bad judgments from others. Bethany C.
Wangelin and Peter W. Tuerk mention in the article PTSD in Active Soldiers: To treat or not to
treat (2014) it may be that soldiers seeking treatment on deployment would expect judgments
by peers or superiors. (p.165). from the time of World War II, active duty soldiers were afraid
to admit they had PTSD because it looked bad on their record. Today, even though more and
more people are coming forward with PTSD, they still are afraid of it being on their record
because it can cause bad judgment from others. (Wangelin C. Bethany & Tuerk W. Peter, 2014,
pg. 165)
According to Mary Webb-Tafoya, in the end the risks depend on the individuals severity
of symptoms and how bad the trauma is, So the risks are entirely dependent on the resiliency of
the individual such at what skills did he/she have to begin with prior to deployment which will
ease the experiences they will endure while deployed and also help them readjust once they
return? What functional coping strategies do they have to deal with their experiences? (Personal

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Communication, 2014) Although the combat veteran or active soldier may go through successful
treatment it does not mean the disorder is gone. If the individual decides to go back to combat, he
or she will have to keep using the skills they were shown through treatment to cope with the
symptoms that can be triggered by any other traumatic experience.
An interview was conducted with Mary Webb-Tafoya who has been working fifteen
years in the field of psychology and has achieved to be a licensed professional counselor in
Texas. She has been working with victims that go through crisis, trauma, sexual trauma, military
and their dependents for ten years. Aside from working with victims she also works at Fort Bliss
as a Military and Family life Counselor. Last but not least, she is an active reservist in the United
States Navy. The interview was conducted on October 17, 2014 at 8:31 am through email. The
overall interview consisted of five questions that were about risks of combat soldiers returning to
combat, how families and combat veterans actually deal with the disorder, and the success rate of
treatment on combat veterans and combat soldiers.
Conclusion/Synthesis
When combat veterans and active duty soldiers go through combat they have one thing in
mind, to lay down their lives for their country. Some come to a point where they realize their
might be a possibility of not coming back home. On the other hand, those that do get to come
home would never see themselves going through the symptoms of Post-Traumatic stress
disorder. Although this disorder can tear families and marriages apart, it can make the individual
and family stronger by going through therapy. Treatment can be so successful that an active
soldier could consider in going back to the combat field and serve their country once again.

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References
Alpert, J. Kent Goosenberg, E. (Directors), & Alpert, J. Kent Goosenberg, E. ONeill, M.
(Producers). (2010). Wartorn 1861-2010 [DVD]. HBO Documentary Films.
Aronson, Raney (Director & Producer.) (01 March 2005). The Soldiers Heart [DVD]. Frontline.
Litz, T. B., & Schlenger E. W. (2009). PTSD in Service Members and New Veterans of the Iraq
and Afghanistan Wars: A bibliography and Critique. The National Center for PTSD,
20(1). http://www.ptsd.va.gov/professional/newsletters/research-quarterly/V20N1.pdf
National Council on Disability. (2009). Section 3: Post-Traumatic Stress Disorder (PTSD) and
Traumatic Brain Injury (TBI).
http://www.ncd.gov/publications/2009/March042009/section3
Paulson, S. D., & Krippner, S. (2010). Haunted by Combat. Lanham. Rowman & Littlefield
Publishers, Inc.
Tafoya-Webb, Mary, personal communication, October 17, 2014).
Wangelin, B. C., & Tuerk, P. W. (2014). PTSD in active combat soldiers: to treat or not to treat.
Journal Of Law, Medicine & Ethics, 42(2), 161-170. doi:10.1111/jlme.12132