Marriage Counseling Is a Backdoor to PTSD Help

Sarah knew there was a problem almost right away. When Sean returned home from deployment, he wasn’t himself.

She shrugged it off. Of course, he wasn’t himself. He had just returned from a war zone. The emotional disconnect, the short fuse, the overeager alcohol consumption ... really, it wasn’t that strange, all things considered.

Of course, they would have to spend some time getting used to each other again. So the small fights all made sense.

Sarah told herself that these weren’t symptoms of post-traumatic stress disorder. These things were just the result of being apart for so long.It’s nothing to worry about, she assured herself. It’s nothing to worry about.

Until the day it was.

The Deciding Moment for PTSD

It was the dog’s fault, really. He was old and kind of rickety and really unsure about having Sean back in the house, even though he’d spent the entire deployment waiting at the door for daddy like the loyal hound he was.

But the dog was confused. As sometimes happens with older dogs, he’d made a mistake in the house. He was already ashamed and hiding under the table.

Sarah had gone to get some paper towels when she heard it -- the slap. The slap, the yelp and the sinking feeling that maybe there was something to worry about, after all.

There were many things Sean was: brave, strong, loving, patient, kind, sincere, honest, loyal to a fault. But Sean wasn’t a dog hitter.

Sarah rushed back into the room, where the baby was now crying because the dog was whimpering and her husband -- her strong, brave, loving, patient husband -- was standing there looking furious.

“I didn’t hit him,” he said at first.

“I didn’t him hard,” he allowed.

“I don’t know what came over me. I didn’t mean to do that,” he whispered.

Owning up to PTSD involves a lot of whispers. It’s not the thing you shout from the mountaintop, even though shouting out is exactly what the spouses of those suffering from it want to do most.

GET HELP! they want to scream. DO IT NOW! they want to yell. THIS ISN’T WORKING AND I CAN’T TAKE IT AND I CANNOT DO IT ALL MYSELF! they repeat. Over and over and over in their brains, they are telling themselves it will be fine, wondering when everything will go back to normal so they can finally breathe again. Just praying it will all go away.

Has it happened to you?

Persistent Stigma Clouds Official Message

In today’s military, the official message is that we have to be honest about PTSD. We have to think of mental health as a normal part of whole body heath and not a cause for shame. Officials, researchers and military advocates openly discuss strategies to fight PTSD and help servicemembers get back up to speed.

Yet when a wife is begging her husband at 3 a.m. to just go talk to someone, the official message and all those pamphlets and everything you’ve heard at the Family Readiness brief suddenly don’t ring true.

The message so many spouses actually hear is: Are you sure it’s PTSD? Are you just making too big a deal of things? And really, doesn’t coming home from war with issues that follow you back just mean you’re too weak for the job?

Maybe that’s part of why it can be so hard for so many servicemembers to seek the help they need: There are a lot of reasons not to.

A Laundry List of Excuses

Sarah knows. Sean had a laundry list of excuses a mile long:

I didn’t lose a limb.

I’m fine.

I wasn’t the one who got hurt.

I’m fine.

I can’t lose my security clearance.

I’m fine.

I can’t pass a polygraph if I’ve gone to “get help.”

I’m fine.

I’ll lose my job.

I have to be fine.

Sarah knew her husband, and she knew, deep down, he needed help. She also knew he was going to put up a fight.

She’d married a soldier, after all. So telling him to “get help” was something she didn’t know how to do.

Even after the incident with the dog, she wasn’t sure what to do. So she whispered it. You need to talk to someone, she said. Someone who isn’t me. Someone who can help.

It wasn’t an easy conversation. No conversation about PTSD ever will be. But Sarah knew when she married a warrior that her life wasn’t going to be easy. That she would bear responsibilities and hardships of war.

This was her fight. As she started, she knew that, at least in policy, the Defense Department stood firmly by her side.

“Many soldiers don't know (or don't share with their wives) adjustments that have been made to SF86, the most standard form used for security clearances,” explains Dr. Betsy Bates Freed, a licensed clinical psychologist in California.

These include two exceptions to reporting mental health treatment: counseling "strictly for a marital, family or grief issue not related to violence by the soldier," or help that is "strictly related to adjustments from service in a military combat environment." In fact, the DoD goes a little bit further: "Seeking support to address behavioral health issues demonstrates inner strength and embodies the Warrior Ethos."

Marriage Therapy May Offer a Workaround

Freed knows a lot about trying to get men to get the help they need -- including how hard it is. So she’s come up with a good workaround: If getting help for PTSD won’t work, try marriage counseling.

“If a soldier believes that such regulations are just hollow policies, not followed in practice, I would suggest that wives insist on marital counseling,” she advises. “After all, symptoms of PTSD do impact the marriage and are therefore an appropriate subject of therapy.”

For wives like Sarah, that’s just the ticket. Sean would agree to marriage counseling. After all, there’s nothing about marriage counseling that indicates a weakness as a soldier.

She told Sean to call it reintegration or call it just a hard time getting to know each other again.

“Either way,” she said, “We’re having a hard time ... and I want to talk with someone to figure out what I can do better. I need you there to support me.”

The marriage counseling route holds water: Anyone living with PTSD at home knows how dearly it affects marriage, and looking to marital counseling as an “excuse” to get help can free the servicemember of the stigma he or she was avoiding.

After all, marriage is messy. Anyone who has ever been in one knows that. Seeking a little marriage counseling is actually pretty run of the mill. And unlike seeking help for PTSD, there aren’t the same feelings of weakness involved.

If anything, a good spouse who cares about the marriage can feel strong in tackling that issue -- especially if they think they are going to support the other spouse.

A Small Start Is Still a Start

If that seems like a big step right away, start small. “Although working with a licensed mental health professional is much preferred, a very wary soldier might be more amenable to "talking with" a member of the clergy about these strains to the marriage,” Freed says. It isn’t the best solution, but it’s a start.

It’s also the start you may have to insist on. “Can a wife insist? Many do,” Freed says.

“Psychologists often talk about two types of mandated therapy: court-mandated and spouse-mandated. Contrary to what you might think, many people do very well in therapy even if decision wasn't their own.”

It isn’t how they get the help that matters. It’s just getting the help at all. When it comes to PTSD, you aren’t powerless. This is the one war the military spouse can fight, too. With your help -- and a little marriage counseling -- it can also be one you win.

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