I’d like to start today by reading you a line from the letter of a young military spouse, and I quote:
“It is infinitely worse to be left behind, a prey to all the horrors of imagining what may be happening to the one you love. You slowly eat your heart out with anxiety and to endure such suspense is simply the hardest of all trials that come to an army wife. “
Those words were penned by Libbie Custer in May of 1876, just after her husband left her for the Little Big Horn. And yet they could have been written -- and probably HAVE been written -- by any of the hundreds of thousands of young spouses who have watched their soldier, sailor, Marine or airman march off to war over the last ten years.
The nature of war changes. Weapons get smarter … tactics get sharper … breakthrough medical advances save more and more lives. But the stress and the anxiety felt by those who are left behind NEVER changes.
Tom Brokaw begins his speeches by reminding the audience that in Afghanistan and Iraq, servicemen and women are waking up, donning their Kevlar vests and helmets, picking-up their weapons and facing another day of war – with all the horror, carnage, and fear – that this entails.
I would like to remind all of you that -- as Libbie Custer so eloquently wrote -- our military families are also beginning their day – filled with worry about the safety and security of their loved ones.
Like Libbie did, they will continue to face the “hardest of all trials.” And they will need our help in doing so.
I simply do not believe we fully understand the terrible impact of the cumulative effects of stress, anxiety, and worry that these families and their loved ones have endured. But we need to try, and we need to do it quickly.
A whole generation has now been impacted. Michael often speaks of the 15 year old whose parent went off to war in 2001 when she was 5 years old. For her entire life, war is all she has known.
Back in Libbie’s day, there were no studies or polls or scientific tests to measure the effect of constant combat on families. There were no programs in place to help young spouses deal with the challenges of child-rearing on remote Army posts or care-giving for a wounded soldier who’s just returned.
Today, we know better. And we know MORE. And while there ARE many programs in place … and there IS a greater understanding overall, we are still discovering, still revealing, fissures and cracks in the family support system.
It is about those fissures and cracks I would like to speak today, in the hopes that we might begin to find new ways to seal them.
The first of those fissures is in something the families refer to as “secondary post traumatic stress.” Not unlike our troops, our families experience the same depression, anxiety, sleeplessness, and headaches.
They break into cold sweats … lose concentration … suffer panic attacks … and come to dread contact with the outside world.
Some lapse into what is known as “anticipatory grief.”
As one spouse put it, “We’re grieving as if they’re already dead, and they’re not.”
As a result, many are unable even to get out of bed – to get dressed, prepare meals, or leave the house. Some won’t even get their children off to school, leaving the care of little ones to the hands of older siblings.
At one installation here in the United States, I have learned of children who missed more than 50 days of school in a year. And this is just one installation.
We should not be surprised, therefore, to learn that some spouses turn to the same remedies that troops with PTS turn to -- alcohol, prescription drugs, and some even contemplate suicide.
Though we do not have an accurate accounting due to medical privacy rules, we do have anecdotal evidence that there are numbers of spouses who attempt suicide. And because we don’t have the same access to them that we do to our troops, there is a real limit to what we know about their feelings and their fears.
I am convinced that much of the desperation these drastic remedies represent is rooted in the stigma still attached to mental health issues.
Not only are they embarrassed to seek help for themselves, spouses worry that in doing so, they could negatively impact a husband’s or wife’s military career. In many cases, the service member even warns the spouse against getting help.
The services have worked hard to reduce mental health stigma in the ranks. But we need to continue to work to eliminate it from our homes as well.
Unfortunately, for some spouses who do seek help, the experience is all too often disappointing. Misdiagnosis. Lengthy waiting periods. Red tape. All of these things discourage and indeed damage the healing process for our families.
During a recent appointment at a post hospital one spouse suffering from classic PTS symptoms -- including suicidal thoughts -- was given five medications but no follow-up appointment.
At the same hospital an active duty female spouse with PTS was given seven medications with no follow-up appointment. Neither was ever referred for psychological help.
Spouses also lament what they call the “15 and one rule.”
It goes like this. No matter WHAT may be bothering you from a health perspective, you are allowed to discuss only one symptom and only then for 15 minutes. That’s it, no exceptions.
If we accept, as we have, that spouses suffer a PTS all their own … and if we know, as we do, that PTS manifests itself in many different ways in many different people, why would we not accept the need to treat the whole person?
Why would we fail to look at the totality of issues confronting a young spouse? And why would we ask that young spouse not to confront them all herself?
You do not have to put on a pair of combat boots and patrol outside the wire to suffer the effects of war. If it is keeping you from living your life and loving your family, you owe it to yourself -- and frankly the military owes it to YOU -- to get the help you need.
That brings me to another fissure we face, help for the whole family … including the children.
We are just now beginning to understand the effects that 10 years of war and multiple deployments have on military children.
There is evidence of elevated emotional and behavioral difficulties and lower academic achievement. Anxiety and depression have led to a rise in the use of psychiatric medications.
In 2009 alone, 300,000 prescriptions for psychiatric drugs were provided to military dependents under the age of 18. Some are no doubt warranted, but I worry that we don’t fully understand the long-term consequences of these medications.
Deployments, as tough as they are, are not the only problems facing military families. Reintegration and reunion are challenges that add to the enormous stresses experienced by spouses, children and service members.
The Army recently also released information that spouse and child abuse cases are rising. We have come to understand that while a combat tour may last a year, the effects of that tour on the service member and family may last much longer.
For the child whose parent received a traumatic physical injury, there may be long term relocation to a military hospital or the child may be left at home with family or friends. For those whose parent has received a signature wound of these wars – PTS or TBI, many don’t understand why their parent looks the same, but isn’t the same.
And for those children whose mom or dad died – either by the enemy or by their own hand – this war will never really end. I meet with surviving family members all the time, and their biggest fear is that we will forget them and the ultimate sacrifice paid by their loved one.
We know our families are proud, patriotic and they have served and sacrificed.
We talk about their resilience and readiness, but we didn’t fully appreciate that these wars would last as long as they have and that resilience and readiness are not permanent. After multiple deployments those things begin to break down.
The Army is now providing suicide prevention training to new recruits – making it a part of the Army culture. So it should be with families.
Building resilient families from the beginning of their military life will hopefully provide an underpinning of strength that can carry them through the most difficult of times.
We need to listen to our families … to better understand THEIR needs, and THEIR special challenges.
One idea that I believe has merit is what I call “home-centered” assistance. For families in crisis, this could be something as simple as having a trained individual -- a counselor or medical professional, depending on need -- come into the home and provide assistance.
It’s about looking at things through THEIR eyes … and trying to find solutions that work in THEIR unique circumstances.
We create lots of new programs all the time, but we don’t always follow-up later to assess how we’re doing. We don’t take the time to break down lessons learned and institute best practices across the services.
Ultimately, spouses tell me they don’t need another program, they don’t need more training. What they need -- what they want -- is time.
Time with their spouses. Time together with their family. Time with a counselor or a doctor or a minister.
They want time to explore and understand what is happening to them … and the patience and understanding of loved ones, friends and the system itself.
As one young Marine wife named Kait Wyatt put it, “It doesn’t matter if it’s the first day they’re gone, or the last day before they return home, you’re scared all the time. You pretend to be happy, but you’re living in fear.”
Kait’s husband, Marine Corporal Derek Wyatt, never made it home. He was killed December 6th while on patrol in Afghanistan. I spoke to Kait as she caressed her newborn son -- a boy Corporal Wyatt never met.
She is mature well beyond her 22 years, far more mature than she should have had to have been. And yet she still admitted to that same fear.
It never goes away, and it never changes.
Libbie Custer had to face the fear alone. But Kait Wyatt and every other modern military spouse should not.
We must do more to recognize them … to adapt TO them and FOR them … and to help them through these “hardest of all trials.”