Introduction

While I was driving across the Coronado Bridge, I saw a man jump to his death.

It was a beautiful May afternoon in San Diego, at around one-thirty. As I drove onto the bridge, I began releasing my morning’s stress and started thinking about the things I would do when I got home. Admiring the boats in the bay, I started daydreaming about changing out of my tracksuit and into my tankini for a relaxing swim.

Suddenly, the car in front of me came to an abrupt halt. The driver-side door opened and a good-looking, well-dressed man in his late twenties got out. He was physically fit and had the grace of an athlete. He turned and faced me. I noticed that he had gorgeous brown hair. His brown eyes looked straight into mine. For whatever reason, I didn’t feel alarmed or upset, even though what he was doing was decidedly out of the ordinary. He was calm and moved without hesitation, so I didn’t think that either he or I were in any kind of danger. I assumed that his car had stalled or broken down and he was going to fix it. He certainly looked capable of it.

My curiosity changed into surprise and then to stomach-turning horror when he quickly moved to the edge of the lane, stepped over the knee-high barrier and fell backward off the bridge.

No hesitation. No ambivalence. He was there one moment, and the next he was gone.

I fumbled for my phone and dialed 911, but it was already too late. There was nothing to do but wait for the police to come.

I later learned that he was a veteran. He went over the side as if it were a military maneuver, which he might have imagined it was: his last mission.

With a little digging, I learned that the man had lost his right arm from an improvised explosive device (IED) while deployed overseas. This detail surprised me, because I hadn’t noticed it when he got out of his car that day on the bridge. I just noticed his face, his hair, his humanity. I also learned he left behind a wife and two small children. My work as a physical therapist and sponsoring SPA Day has connected me with many other men and women who had returned from combat injured, just as he had. According to the US Department of Veterans Affairs (VA), recent veterans are at a significantly higher risk of suicide than the general population. A study of veterans who served during the Iraq and Afghanistan wars found that warriors returning from deployment were 41 to 61 percent more likely to commit suicide compared to their civilian peers. These are some sobering numbers.

While it’s understandable that military personnel would have limited access to support while they’re deployed, it’s obvious that they need it once they return to civilian life. The man who jumped off the bridge wasn’t one of the patients I worked with, but he could have been. I had worked hard to become a skilled physical therapist, both in school and as a working professional, yet I knew very little about the severe clinical depression that often pushed our patients over the edge.

After that day on the bridge, I was determined to learn more about this problem, and once I did, I knew I had to get more involved. The stories that follow and the information I’ve gathered from experts are my contribution to a small but growing body of knowledge about postwar life for veterans and their caregivers.  Although I had been sponsoring a support group for the wives of wounded warriors since 2008, this was the turning point for me to share their stories. I hope that reading these stories will help more people comprehend our responsibilities as a nation to help and support not just our brave veterans of lengthy, modern-day wars, but also the spouses and families who live with and care for them.

Chapter 1

Why Is My Husband So Angry? Dealing with Posttraumatic Stress

The bigness of the world is redemption. Despair compresses you into a small space, and a depression is literally a hollow in the ground. To dig deeper into the self, to go underground, is sometimes necessary, but so is the other route of getting out of yourself, into the larger world, into the openness in which you need not clutch your story and your troubles so tightly to your chest.

                                                                  —Rebecca Solnit, The Faraway Nearby

After the morning spa massage sessions at the Hotel del Coronado, the women gathered to eat lunch, sip water, and stir tea. What began as an informal conversation between a few women about the morning’s relaxing activities soon evolved into something much more serious. Many of the women were now participating in a discussion that drew them all into a tight circle to comfort the storyteller.

Julie told her story through wracking sobs, one hand cradling her round face and the other raking her thick, blond hair.

“I hate Afghanistan,” she said. “When Jason went over there, he was a warm, outgoing person. But he came back angry and withdrawn, and he began taking out all his anger on me and the kids.”

Drawing nods of agreement and sympathetic encouragement from the others, Julie continued. “I just don’t understand. I hardly recognize him. This new man fights with recurring flashbacks, rage, overprotectiveness, depression … It’s all so hard to cope with.”

Julie, like many wives of wounded warriors, felt abandoned and alone, even though she was still living with Jason. She wondered aloud why he had turned on their family—the ones he loved the most.

The other wives in the group had the same concerns. A firebrand of a woman named Jane said, “It’s like we’re all married to the same man with different faces, and he’s having an affair with another woman.”

I thought to myself that the other woman’s name is Iraq or Afghanistan. She may be ugly and battle-scarred, but she still calls out to the men who know her. They can’t resist her call.

Posttraumatic stress (PTS)—also known as shell shock, battle fatigue, or soldier’s heart—can be described as a locked trunk full of unwept tears. Every soldier deals with the experience of combat differently. Some shut off their emotions, while others feel every moment deeply. These coping mechanisms become ingrained, and when soldiers return to their families, they find themselves numb to some feelings and oversensitive to others. Their reactions become volatile and unpredictable, swinging from alienation and betrayal to rage and regret. Often these feelings are compounded by a profound sense of survivor’s grief, along with helplessness, self-pity, and anger.

One wife described her husband’s PTS as a cycle.

“First he expresses it by acting out in anger,” she said, “attacking an innocent person who he sees as a threat to us. Then later, he turns it inward, shutting me out, drinking alone at bars in a deep depression. I can’t convince him that he’s home safe now, that there aren’t any threats, or even that I love him.”

PTS can affect anyone who has experienced a traumatic event such as sexual abuse, a terrorist attack, or other assaults. In life, we all face crises large and small, ranging from the loss of a cell phone to the death of a loved one. Yet these events, while stressful, aren’t typically considered traumas unless we are unable to cope. A trauma is an event of such magnitude, horror, or duration that it overwhelms a person’s emotional and physical coping mechanisms. The resulting traumatic stress interferes with the person’s day-to-day functioning. The condition becomes a disorder when the sufferer’s behavior becomes maladaptive and destructive and interferes with daily living. It’s a continuum that ranges from feeling mildly depressed to being unable to get out of bed in the morning. PTS is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

In essence, PTS is a severe reaction to an abnormal or overwhelming amount of stress. Imagine witnessing a succession of terrible car crashes, knowing there’s a chance you might be the next. Or being raped twice a week for years. Even if these terrible things were not happening to you directly, imagine that they were happening to people all around you and you were powerless to stop them. What if you knew that, at any moment, you might be the next victim? Naturally, PTS is common among war veterans, but it can develop in the wives of wounded warriors, too.

PTS isn’t a sign that an individual is psychologically weak, as shown by the fact that it develops in survivors of a variety of natural catastrophes, many of whom had no previous significant mental health problems. PTS can also develop in persons who witness trauma on a daily basis or are subjected to persistent and unrelieved stress as part of their jobs. This is true even for individuals who are carefully screened for mental health problems prior to admission into their fields. For example, PTS is common among rescue workers, firefighters, health care teams, and police officers. The symptoms have also been noted in prisoners of war, Holocaust survivors, and people who witnessed or were first responders to the attacks on the World Trade Center in 2001.

Sharing the stories of their husbands’ PTS episodes can be crucial for wives of wounded warriors, who must learn to identify and understand PTS symptoms. These women must also learn to take steps—including getting help—to ensure the safety of their children, themselves, and the men in their lives.

Another concept that pops up on the radar while the women talk is moral injury. This might seem like it could get lumped in with PTS, but the mental health community has determined that while PTS stems from fear, moral injury has to do with an individual’s sense of right and wrong. The symptoms are similar and can include depression and anxiety, difficulty paying attention, and loss of trust. But the morally injured feel sadness and regret, too. They are trying to reconcile the ethics they brought to battle with the ugliness of conflict.

As I listened to these women share their stories during lunch, I was amazed by how easily they opened up to each other. When I was going through my divorce, I had a hard time confiding in others. I felt that my troubles were just that—my troubles—and I didn’t want to burden anyone else with them. I was embarrassed that my marriage hadn’t worked out and didn’t know how to express my feelings. If I had been more open about my struggles—taken a page out of these women’s playbooks—perhaps I could have healed faster.

While the stress of my divorce was nothing compared to what these women were going through, it was heartening to witness them listen to each other and offer support. I can only imagine what a relief it must have been for these women to hear from others who were experiencing the same challenges. Connecting helped them see that they were not alone.

As the women continued sharing, it became clear to me that Julie’s story had important parallels with those of other women in the group, and that they’d found the same ways to cope with their hardships. Each woman felt that living with her spouse’s PTS was like being trapped in a small, stress-filled, pressurized space. Talking openly about it had, for a time, made that space bigger.

I’d like to share more of Julie’s story with you, then introduce Jane, another wife from the group who reached similar conclusions about how to heal the rifts in her marriage and move beyond the pain of her husband’s trauma. If you, too, are the wife of a wounded warrior, I hope their experiences and ideas can help you do the same.

Julie: I Will Quiet the Unheard Screams

“When my husband came back from his third deployment, physically and emotionally wounded, everything was different,” Julie said, her voice soft and her eyes downcast. “Who was this stranger?” Jason had been shot in combat. He felt he’d gotten off easy with just an arm injury. Two of his friends had died during the attack, and he harbored a huge amount of survivor’s guilt. Even though Jason couldn’t talk about it, Julie felt the incident was never far from his thoughts. She came to believe that while his body might have returned, a piece of his soul was still over there.

Julie had met Jason in 2010 while they both served in the marines. She was nineteen, stocky and tomboyish, strong like all sailors. Jason, who grew up in the South, towered above Julie at six foot two and melted her heart with his soft brown eyes. “The thing that attracted me most,” Julie confessed, “was his go-to-it attitude. And the way he smelled, which was really nice.”

She remembered him as a warm, fun-loving man, social and relaxed. He got along easily with friends and family, and he went out often. After they married in 2012 and had children, Jason played happily with their two young sons, Greg and Tony.

Julie came to understand that she was reconciling two very different versions of her husband. The man who returned from deployment looked just like the one she had married—tall, dark, and handsome. But he was often irritable or irrational, and he became silent and sullen with no warning, withdrawing into anxiety and depression for days. Julie would offer up ideas for outings—such as enjoying a Padres game or going out with friends for a beer—but Jason was seldom interested. She couldn’t even tempt him with fishing, one of his favorite pastimes. Days turned into weeks, and his irritability and anxiety pulled him further and further inward. No matter what Julie tried, she couldn’t get Jason to leave the safety of their home.

“He wouldn’t make eye contact or even get out of bed. He quit shaving and showering. Nothing interested him, and we argued over little, stupid things. In all honesty, sometimes it felt like I was caring for three children instead of two,” Julie told us. “He couldn’t see a reason to get up every morning. He played a song, ‘What’s This Life For,’ over and over again for what felt like months.”

What had happened to Jason over the course of his three deployments? He didn’t share many stories, and Julie felt shut out.

“It’s really tempting to dig for the details of what happened—we’re human. Heck, we’re women, so we instinctively want to know all the details,” Julie told the other wives. But she was afraid of what might happen if she prodded him too much and triggered those feelings of guilt and betrayal.

Jason’s default state for emotional security was silence. Sometimes he would share what he had experienced on his deployments in small bursts, but more often he wouldn’t. He just couldn’t find the words. Nights were long as Julie watched his fitful sleep. She could still remember what it felt like to be wrapped up in his strong arms, but now she felt empty and abandoned.

Julie was able to face those long nights and silent days because of a deeply held belief that things would get better with time. She played the song “I Won’t Give Up on You” by Jason Mraz to remind her husband that she was there to support him. She asked him to go to therapy at the VA. It took a while to persuade him, but eventually Jason agreed. As they walked into their first session together, Julie took his enormous hand in her own and told him she wouldn’t give up on him so long as he didn’t give up on himself.

The therapist listened without judgment and inquired about Jason’s obsession with the song that asked, “What’s this life for?” The therapist couldn’t give Jason a meaning and purpose to life, but by asking the right questions he helped Jason find those things for himself and find reasons to get up most mornings.

Julie related some of the things Jason shared about his combat memories in these sessions. “The first time I killed was a high. This fucker was going to kill us, but I killed him instead.”

Good therapists understand that they don’t always know what’s best for their clients, and help normalize traumatic experiences by saying, “How did you have the strength to respond that way?” and, “I don’t see how you could have done anything different at that time.”

Eventually, Jason opened up about the events surrounding his injury and the trauma he’d experienced. He revealed that he had been part of the group responsible for training the Afghan police.

It had been a long, hot, stressful week of training and patrol. Jason was daydreaming about being safe at home and jumping into the ocean; he missed his freedom andcouldn’t wait to get out of that shithole. Those were his exact thoughts, he told the counselor, when he heard a bang. His body clenched and stiffened. He turned around. One of the members of the Afghan police they’d been training had turned his gun on his comrades.

Bloodlust coursed through Jason’s veins as he sprang into action. He was shot trying to stop the “insider” attack from injuring or killing more of his friends. He didn’t even feel the bullet as it pierced his right shoulder and shredded his right arm.

 Jason lost two of his closest friends in the attack. He lived the nightmare of seeing his best friends killed. In his mind, he replayed the episode over and over. He also grappled with self-doubt: Had he reacted too slowly? Could he have done something more to save his buddies? Why didn’t he see the attack coming?

Jason’s experience isn’t unusual and, in light of what he experienced, it’s understandable that he would struggle to downshift into civilian life. Everyone who has been deployed to a war zone is changed by his or her experience; it would be abnormal not to be. The journey of readjusting after combat is one of learning to live with traumatic experiences and integrate them into postwar life, without blaming oneself for what did or didn’t happen. Wounded warriors must retrain themselves to communicate, and it’s a long, painstaking process. They must figure out how to react to situations as nonwarriors, even try to reclaim a little bit of who they were before they became warriors.

“Jason does his best with our boys, but he gets aggravated a lot faster than he used to,” Julie said. “So when he brought home Why Is Dad So Mad? by Seth Kastle, it meant a lot to me. Just him reading that book to the kids was a big help, and everything in it is pretty much true about Jason. [Those passages] helped the boys better understand what was happening with their own dad.”

Jason received a prosthetic arm, and after a year of occupational therapy he felt able to leave the house, but only on his really good days. As he gradually became more social and visible, Julie began encountering another kind of frustration: people who knew nothing about their situation would sometimes sit in judgment. “He seems just fine to me,” she would hear, or, “He was normal the last time I saw him.” Other friends and family would accuse him of faking his condition, saying things like, “He has a new arm now. Can’t he just get on with it?”

For Jason, this wave of unfeeling, unthinking remarks inflicted new, invisible wounds. For Julie, the harsh comments were stunning­ at first, but she soon learned to consider them a blessing. The way people responded to her husband’s condition often revealed their true character, underlying ignorance, or lack of ability to be supportive. Just as we slow down and look carefully when we approach a flashing light at an intersection, Julie learned to assess possible emotional collisions and steer clear of certain individuals.

Even as Jason was progressing in his recovery, Julie realized she needed more support for herself. She reached out to a number of service organizations, including a group that held caregiver meetings at the Vet Center. She discovered that other women were experiencing similar frustrations. She wasn’t alone in her struggles. The group referred her to the Operation Family Caregiver program, where she learned problem-solving techniques. One of Julie’s looming worries was that she didn’t have an exit strategy if Jason eventually did give up on himself. She had drawn a line in the sand, saying she would leave if he didn’t truly commit to therapy and his healing processes, but she wasn’t sure she could support herself if it came down to that.

A counselor shored up her confidence and helped her find full-time work so she could make good on her ultimatum. If her husband quit going to group and individual therapy, she could and would leave.

Through her own therapy, Julie also learned how to accept and cope with this new, different Jason. First she addressed her husband’s silence. She learned that when he became silent, it wasn’t something she should take personally. She came to understand Jason’s need to process information at his own rate, and that forcing him to share details before he was ready could hinder his recovery. Instead of feeling frustrated, she opted to cultivate her patience.

As difficult as the dark days were, moments of light did begin to grace Julie’s life. She became the top salesperson at her local sports store and started teaching fly-fishing classes. She even learned how to tie flies. In time, she found her own ways of staying centered. Simple practices such as venting with friends, listening to music, taking a drive, or going shopping helped her stay calm and maintain her sanity throughout this difficult period. An unexpected side effect of her experience was that she learned what she was made of, as a wife and as a person.

“You never really know what you have in you until something brings it out of you,” she mused.

Now that Julie had the added responsibility of being the primary breadwinner—on top of caregiving, mothering, cooking, cleaning, and shopping for the family—she realized she was capable of juggling more than she’d ever imagined. Although she had retired from the marines long ago when she found out she was pregnant, her military career had given her confidence and organizational skills she could tap into as she cared for Jason.

“I discovered that I am a very patient and easygoing person,” Julie said. “It’s not an easy job to take care of two kids and another adult, but I make it happen to keep our family together, like it should be.”

Just as a long, rainy day has moments when the rain subsides, so did the emotionally rainy days of Julie’s life. She didn’t take a single sunburst for granted. If some friends were getting together for a short getaway, she was definitely game so long as she could find help with childcare. (Jason could only watch the kids for brief periods of time.) If Jason was having a good day, she was all his and enjoyed just spending time with her family. She had made a successful transition into civilian life and knew, deep down, that he could too.

On one of her getaway days fly-fishing, Julie learned about Project Healing Waters, a program dedicated to the physical and emotional rehabilitation of disabled veterans through fly-fishing and related activities. Recalling Jason’s lifelong love of fishing, she signed both of them up for a Healing Waters retreat.

“Fly-fishing with the love of my life on a quiet river brought back our flow,” Julie said. “These quickly became the moments we valued the most. Jason became certified as a fly-fishing instructor, and I worked as a guide during the summers. It allowed our family to get away from it all in nature.”

Learning to tie flies (he can tie them with one hand) and cast taught Jason to adapt to his injuries and gave him a new skill he could be proud of. He didn’t think he’d ever find anything as meaningful as bonding with his comrades in the military, but Julie’s encouragement inspired him to be curious and try new things. Although he’d fished, Jason never had an interest in fly-fishing until his wife introduced it to him. Sharing her passion brought them closer together.

Today, Julie is hopeful about the future as both she and Jason continue certification courses to make fly-fishing instruction a full-time career. The Project Healing Waters program is international now, and the couple plans to follow the world’s waterways to other veterans. Jason feels as though he’s moving in a new direction after his military career and his healing is an example of hope for others.

“Going out on the water and forgetting about Afghanistan even for just a few days satisfies my soul,” he explained to Julie.

Now when the world gets too stressful, Jason knows he has other options besides retreating into solitude and depression. Being on the water gives him a feeling of belonging in the universe, and that connection is crucial. He no longer wonders if there’s a point to living when he’s fly-fishing with Julie.

“It’s just us, the water, and the fish,” Julie said. “Helping other veterans learn to fly-fish has given us both new meaning, purpose, and peace.”