WASHINGTON (AFPN) -- Money, intimacy and re-establishing their relationship as a couple and with their children are some of the challenging issues facing families when servicemembers return after months away in Iraq or Afghanistan.
A team of mental-health professionals from the Center for the Study of Traumatic Stress, part of the Uniformed Services University of the Health Sciences, has been looking at these issues through interviews and visits to Defense Department communities as part of a health education campaign, "Courage to Care."
How spouses spent combat pay was raised as a major concern of returning combatants, said Col. (Dr.) Molly Hall of the psychiatry department at the university.
Center team member Dr. Nancy Vineburgh visited Fort Polk, La., and sat in on a reintegration class for Soldiers who recently returned from Iraq and their spouses. About 75 percent of the servicemember attendees brought their spouses with them. The spending topic came up in an interactive exercise in which two servicemembers without spouses role-played a couple discussing an important issue.
"What have you done with my money? You spent it on the house? I wanted a car!" said one servicemember to the other. Dr. Vineburgh, an assistant professor of psychiatry at the university, said such an issue becomes part of a larger picture of re-establishing a relationship of trust and mutual respect.
She said a money issue, such as the wife buying new furniture while the servicemember may have wanted a new car, could cause a lot of friction in the relationship. One wife said she was able to save a lot of money while her husband was fighting a war, "but some people didn't," Dr. Vineburgh said.
The purpose of the reintegration class was to discuss the challenges of getting back into the family life and reconnecting with spouses, she said. The facilitators included a chaplain and several family-advocacy representatives, including health-care providers and community services staff.
Other big issues voiced by returning war veterans centered on the tremendous transition from the regimented, intense routine of war back into an environment that is quiet and safe, Dr. Hall said.
"It's a transition back to life in the states with the family and all the demands that suddenly spouses and children present," she said. "Life is actually in some ways more ambiguous, less structured and less clear here as opposed to life in Iraq and Afghanistan."
Normally, people do not immediately think about potential problems associated with transitioning back into the family after being in combat, Dr. Hall said.
"You kind of key on, 'It's wonderful to be back together again the first day,'" she said. "But, about a week (later), all of a sudden, you might have an issue where parents coming back encounter a family structure that's become very self-sufficient in that member's absence.
"Maybe the discipline has changed; maybe the roles have changed," Dr. Hall said. "So there has to be kind of a (reassembling) of the unit."
"We tend to romanticize when we're not together," Dr. Vineburgh said. "Things suddenly seem more important or more special than they might have been."
Another problem arises when the spouse returns to the workforce during the servicemember's absence, which leads to more independent feelings, Dr. Hall said.
"Whereas, before the member left, (the spouse) may have been functioning more in a traditional homemaker role," she said. "Now that they've branched out, that's an issue that perhaps needs to be discussed and negotiated."
While the servicemember is off fighting a war, the parent left alone with children might have different disciplinary styles, bedtimes and ideas of what children can and cannot do, Dr. Hall said.
When the combatant returns home with different ways of doing things, the child might rebel and say, "That's not the way we used to do it," or "That's not the way Mom did it," Dr. Hall said.
Sleep disruption also was discussed as a problem in the reintegration class. For example, one of the facilitators, a wife who had experienced reintegration, said how difficult it was to have her husband return and take up the whole bed, tossing and turning.
Intimacy can become a big issue with just one touch, Dr. Hall said.
"This is particularly true for combat veterans who are accustomed to being constantly on guard, constantly vigilant and constantly looking out for harm," she said. "When you're in that kind of state, if somebody comes up behind you and just touches you casually, you can really have a difficult time with that. So one issue is just getting comfortable again with physical affection, just physical touching."
One of the most difficult issues expressed in the reintegration class was closeness. Many servicemembers who had just returned faced possible redeployment, and this unknown affects couples trying to re-establish their relationship, Dr. Vineburgh said.
"Just how close to get is an issue when you know you might be soon separated," was just one of many poignant remarks that epitomize the emotional challenges of servicemembers and spouses, she said.