War scars can follow troops to bedroom
MINNEAPOLIS -- Mike Mills didn't look in a mirror for two months after a land mine blew him out of his truck near Kirkuk, Iraq, in June 2005, cracking his clavicle, shattering his hip "like a jigsaw puzzle" and burning off half of his face. When ...
MINNEAPOLIS -- Mike Mills didn't look in a mirror for two months after a land mine blew him out of his truck near Kirkuk, Iraq, in June 2005, cracking his clavicle, shattering his hip "like a jigsaw puzzle" and burning off half of his face. When he did, only one word came to him: "Freak."
Recovering at Brooke Army Medical Center in San Antonio, Mills worried about his two kids in Freeport, Minn. He worried about making a living. Mostly, he worried about Suhanna -- Suki -- his wife of nearly 20 years, who would surely leave him.
"How can I expect her to stay with me anymore?" said Mills, 43, a member of the Minnesota Army National Guard for 18 years. "She's not going to want to be intimate with a freak. Elephant Man. That's the way I saw myself." Suki, 43, didn't leave. "I'm too old to train in another one," she joked.
She changed her husband's pus- and blood-soaked bandages, and helped him relearn how to shave and brush his teeth.
As the Mills family moves forward, the U.S. Defense and Veterans Affairs departments are acknowledging that the physical and emotional scars that troops carry home present a sensitive challenge: sexual intimacy and body-image issues that most couples' therapists are ill-prepared to treat.
Many factors play a role. More than half of the troops -- 56 percent -- are married, many for decades. That means lots of spouses issuing ultimatums to get help or get out.
In addition, the war's ubiquitous battleground and multiple deployments have left an estimated 40,000 troops with post-traumatic stress disorder, a syndrome unequivocally tied to marital distress, as well as brain injuries, burns and loss of limbs -- horrific injuries that, because of protective Kevlar vests, are no longer fatal.
The number of people returning with disabilities, is an "enormous problem ... an astonishing problem," said Eli Coleman, director of the Program in Human Sexuality at the University of Minnesota. "Combined with the fact that returning vets are usually older and partnered, this is having a devastating effect on relationships."
One bright spot is that a predicted spike in divorce rates might have been overstated. A yearlong study by Rand Corp., published in 2007, found that after a brief rise beginning in 2001, divorce across all military branches stabilized at 3 percent in 2005, the same rate as in 1996. But the study's authors noted that no one can predict the long-term fallout for couples.
The short-term effect is evident. The Minneapolis VA Medical Center, which already provides couples therapy, has expanded to focus on sexual and combat trauma for couples, and is refining that treatment with data being collected from 50 military couples, said VA researcher Christopher Erbes.
Its work, among the first of its kind in the nation, is modeled after a successful treatment program at the VA National Center for PTSD in Boston. And sex was front and center at the Wounded Troops and Partners conference in Washington, D.C., in May.
While sexual problems might seem like a curious concern during wartime, the conference brought home the urgency: a failed intimate relationship was the reason cited for nearly three-quarters of last year's military-related suicides, said Mitchell S. Tepper, of the Center of Excellence for Sexual Health at Morehouse School of Medicine in Atlanta.
"The mirror is such a powerful experience," said Tepper, who is pushing for a national dialogue about how to support healthy intimacy among military couples. "The first time you see the reflection of your changed body, whether sitting in a wheel chair, or severely disfigured because of facial burns, it is shocking. People who are not married look down and ask, 'Will anyone ever be interested in me?' If they are married, they wonder, 'Will my partner still find me sexually attractive?' Facing issues of body image and sexual self-esteem are pretty universal."
Abby Jackson, 25, understands. Her Iowa National Guardsman husband, Robert Jackson, 27, returned home from Iraq with both legs amputated below the knee.
"I knew that I wanted to be intimate again," said Abby, quoted in a transcript from the Wounded Troops conference. "I knew that I definitely wanted to have more children, and I knew that he was not interested in me and so a big red flag to me was, well, what did I do? Why does he not want to have sex? Why does he not want to touch my hand, or why is he not asking me to get in the bed? Am I the only one that is feeling like I want in the bed?"
Hardly. Candice Monson, deputy director of the Women's Health Sciences Division of the VA National Center for PTSD, said sleep disturbances are yet another problem for partners.
Without effective and targeted couples' therapy, Monson said, "this war can result in separate bedrooms and sexless, loveless marriages 25 years down the road."
Hanging in there can pay big dividends. The Jacksons of Iowa did regain their intimacy, evidenced by a busy 2-yearold and a 6-month-old joining their two older children.
The Mills, parents of Aaron, 18, and Kenzie, 13, also continue to draw strength from each other. Three years after his traumatic injuries, Mike looks in the mirror now and says with a smile, "I was good looking before and I'm better looking now."
Suki has adjusted to the fact that her husband lost most of his left ear, 2½ fingers and will have pins in his hips for the rest of his life. He can't quite wrap his left arm around her anymore, but she can still fit her head into the crook of his neck.