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Taking Stress Out of Reintegration

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The Defense Department is working to "fundamentally transform" the nation's understanding of the invisible wounds of war, Defense Secretary Leon E. Panetta has said, and nowhere is that more apparent than at the Defense Centers of Excellence for Psychological and Traumatic Brain Injury.

DCoE is out in front on recognizing psychological problems among service members and recently began reaching out to military members and their families through social networking.

One event, now common in military family life - that also can be largely misunderstood - is a service member's redeployment home. Navy Lt. Cmdr. Dana Lee, a psychologist in reintegration and deployment health at DCoE in Silver Spring, Md., recently took part in a Facebook chat with families about how to give service members a smooth transition back into their home life.

People often have unrealistic views of how a redeployment will be, Lee told me in a follow-up interview. "A lot of people think of it as a series of positive events," she said. "You're reunited with your family and friends, you're going back to your favorite restaurants and activities."

But returning to the routine of home life after war also can be a "period of extended stressors," she added. "There are expectations that come with coming back. When you're deployed, you're focused on mission completion. There are different routines at home."

A lot of things happen in the months that a service member is away, Lee explained. The kids have grown and changed, maybe the house is different, there may be a new car, and the couple's relationship may have changed.

Many couples - or one member of the couple - may want to dash off to Disney World or throw a big party or family reunion for what many see as the ultimate celebration. But some redeploying service members may need down time to decompress, Lee said.

Communication is key to understanding what the service member wants and needs, Lee said. "Include your service member in the planning process so they can have a say in what is happening," she said.

While some reintegrated troops are ready for a big welcome-home party, some may be exhausted or overwhelmed by that, Lee said. "Some people when they just get back, all they want to do is catch up on their sleep," she said. "Some may sleep 20 hours a day for a few days just to catch up.

"The service member may be thinking, ‘I just want to get the basics done: relax, sleep, have a good burger.'"

Reintegration should be viewed as a process, rather than a timed event, Lee said. There is no set time in which a service member should feel fully acclimated, she said.

Reintegration affects the whole family, Lee said, and family members should understand that it is OK to spend time apart. "It's OK to look at your routines and do what you need to do for yourselves," she said.

Families should talk about the changes openly and, if a service member is deployed, start the conversation then. "The conversation should not start as soon as the service member gets back," she said.

It is common for troops to have disagreements or flashbacks as they reintegrate, Lee said. Some signs that a service member may need professional help with reintegration is if he or she has excessive anger, depression, symptoms of post-traumatic stress, is using illegal drugs or misusing prescription drugs, or drinking alcohol excessively, she said.

"It goes back to functioning," Lee said. "If you notice increased anger and it's really not the same person you knew before deployment, and the anger is impacting family relationships, or if they are isolating themselves," then it may be time to reach out to a counselor or clergy members, she said.

"We know that when you break your leg, you're going seek treatment," Lee said. "But it's also vital that people with invisible wounds seek help, too."

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