Invisible Wounds

Published on 19 September 2007 by

Category: New Blog Posts, Updates


From Brad Klontz

Everything seemed fine at first. After serving fifteen months in Iraq, Carlo was happy to be home. It was great to be back with family, surfing, and working in the family business. But six months after his return, the dreams started. While Carlo came home uninjured, many of his friends weren’t so fortunate. On one patrol, Carlo’s unit was ambushed and his best friend was killed. Every night for the past month, Carlo has relieved the experience in his dreams. He wakes in a cold sweat and out of breath, overwhelmed with feelings of fear, sadness, powerlessness, and anger. Lately he has had trouble focusing at work as he can’t stop thinking about the incident. When news of the war comes on television, Carlo will change the channel or walk out of the room. More than once a loud noise has made Carlo jump, and one time he even dove to the ground to take cover. Carlo’s wife is beginning to complain that he is “distant” and “aloof.” Carlo finds himself becoming increasing irritable and short-tempered with his children.

Carlo is not alone. According to Lieutenant Commander and Navy Psychologist Dr. Erick Bacho, approximately 30% of returning soldiers experience significant mental health concerns. More than half of those, like Carlo, experience symptoms of posttraumatic stress. Since the Civil War, health professionals have noted the mental and emotional effects of war on soldiers. Terms such as “shell shock,” “combat fatigue,” and most recently, “posttraumatic stress,” have been used to describe an invisible emotional wound that can be just as debilitating as physical injury. Posttraumatic stress can follow an experience in which a person feels terrified, powerless, or at risk of severe harm or death. Individuals suffering with posttraumatic stress try to avoid thinking or talking their experiences. Despite their efforts, they may be flooded by thoughts, images, and overwhelming feelings triggered by even the slightest reminder of the trauma. They may startle easy, have trouble relaxing, or feel the need to check over their shoulder. Feelings of anxiety, nightmares, or “flashbacks,” – in which they feel like they are reliving an experience while fully awake- can begin to take over their lives.

War veterans experiencing posttraumatic stress often find it difficult to return to a normal life. It is difficult for them to talk about their experiences with their family, friends, or coworkers. They may not want to upset those they love with disturbing details, may feel guilt about what they did or did not do, or may fear being misunderstood or judged by those who can’t relate to their experiences.

Research has shown that psychotherapy can help Carlo heal. Providing Carlo with a safe place to confront the details of his traumatic experiences and process the associated thoughts and unresolved emotions can relieve him of his symptoms of posttraumatic stress. Unfortunately, according to Dr. Bacho, less than half of returning soldiers who experience mental health problems seek mental health services.

Carlo’s family and friends can play an important role in helping him heal his invisible wounds. Dr. Bacho recommends that families and friends consider the following tips to support returning veterans: 1) Plan a special homecoming for the returning soldier, which may include banners or a special meal. 2) Anticipate a “post-honeymoon” period. After the initial euphoria of the return, it is normal to feel out of synch with loved ones because all have grown and changed during the separation. It is not uncommon for symptoms of anxiety and depression to appear weeks or months after the reunion. 3) Ease into intimacy. It may take time to reestablish physical and emotional closeness after stressful situations. Spend time talking together. Sometimes it’s easier to connect if you talk while doing something together, like taking a walk or working out. 4) Be patient. Fatigue, confusion, and worry can lead to short tempers and hurt feelings. 5) Expect children to test the rules when both parents are home. Set aside time with your spouse to come up with a parenting and household duties approach you both agree on (e.g., discipline, child care, housekeeping). 6) Know when to seek help. If you, your spouse, or other family members are feeling signs of physical or emotional stress, misuse of alcohol, or sleeping problems, it’s important to seek expert help.

Regardless of one’s political views, Carlo, and all other returning soldiers have answered their country’s call to service. They have volunteered to put themselves in harm’s way to serve their friends, families, and communities. Now as friends, families, and community members, it is our turn to serve them.

Dr. Brad Klontz is the 2007 President-Elect of the Hawaii Psychological Association and coauthor of The Financial Wisdom of Ebenezer Scrooge. He can be reached by e-mail at For free, confidential referrals to a psychologist in your area, contact the HPA online at or call (808) 521-8995.


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