There are some military service-connected disabilities that are visible, such as amputations, burns, and physical scars, to those passing by.  On the other hand, there are many service-connected disabilities resulting from military combat operations that are unseen and invisible to those the combat veteran comes in contact with on a daily basis.  Only those who know the veteran most closely knows the struggles they go through on a daily basis.  These invisible wounds impact not only the veteran returning from a combat deployment, but also have lasting impacts on family dynamics, the veteran’s children, spouse, their marriages, and relationships.  Despite the short and long-term challenges of service-connected disabilities, there is freedom in Christ and dealing with the challenges facing these veterans and their families.

How do Christian counselors begin to address some of these issues the veteran and their families go through?  What are some of these invisible wounds?  Where does freedom in Christ come from and how does one obtain such freedom?  Much of the basis for  

Christian counseling comes from journals, books, and men and women’s experiences throughout the years in treating clients and patients.  However, one can simply turn to the Word of God to begin peeling away the layers from the onion and begin a successful treatment plan. 

In one of Jesus’ most famous and often quoted sermons, He speaks to the hearts of those who have gathered to hear Him speak.  In Matthew 5:3-4, He teaches, “Blessed are the poor in spirit, for theirs is the kingdom of heaven.  Blessed are those who mourn, for they shall be comforted” (Steadfast Bibles, 2021).  Elsewhere, in Psalm 34:18, God says, “Yahweh is near to the brokenhearted and saves those who are crushed in spirit” (Steadfast Bibles, 2021).  Now these are just a few of the many verses throughout Scripture that speak to those who are internally hurting.  Each and every day, you are passing by people who are fighting struggles that you probably are oblivious to.  Their battlefield is no longer on foreign soil and against a foreign enemy.  The battlefield exists within their mind, there is no rest or relief from the enemy, and the fighting is relentless.  There is hope in the healing power and name of Christ for these war-wearied men and women.  Jesus calls us to draw near to Him, as we see in James 4:8, Psalm 145:18, and elsewhere throughout Scripture (Steadfast Bibles, 2021).

Service-connected disabilities, like Post Traumatic Stress Disorder (PTSD), have been known to have a ripple effect on the psychological state of not only the combat veteran, but also their spouses, significant other, and children.  This ripple effect has been found to have caused secondary Post Traumatic Stress Disorder Symptoms (PTSS) within the veteran’s spouse or significant other (Zerach & Gordon-Shaley, 2023).  Traumatic events, specifically those experienced in military combat operations, put those veterans at a high risk for long-term mental health disorders.  PTSD is the most common disorder found amongst veterans returning from combat deployments.  Before looking at how PTSD further affects the veteran’s family, it is important to understand how PTSD can be characterized and what it does.  Veterans suffering from PTSD frequently deal with the intrusive reexperiencing of the traumatic event(s) from combat, avoidance of reminders of the trauma, alterations and changes in arousal and reactivity, and persistent negative alterations in cognitive functions and mood.  After combat, between 6% to 25% of veterans reported to suffer from PTSD (Zerach & Gordon-Shaley, 2023).  How then does PTSD, which is unseen by many, have such a huge impact on the family members of the veteran suffering from PTSD?

Parental disabilities can significantly impact the quality of the environment within the home (Lakdawala & Bharadwaj, 2022).  The relationship between a parent and their child can often be affected by the experiences of traumatic events, negative life events, and chronic physical, mental, or emotional illness (Zerach, and Gordon-Shaley, 2023).  A child, from when they are an infant to when they are an adult, has certain expectations regarding their relationship with a parent.  Throughout their life, the child looks to the parent as a source of security, strength, comfort, and stability.  When one or both parents suffer from a disability such as PTSD, the expectations, and the stability of the relationship between them and their children suffers. 

Another way parental disability effects children are when a non-disabled spouse provides care of their disabled spouse.  This inevitably reduces the amount of time the parents are able to spend with their children.  Cognitive disabilities such as PTSD has been associated with higher levels of family violence, marital and relationship conflicts, and family distress. 

A twelve-year study conducted by the American Community Survey (ACS) that focuses on the relationship between parental disability among veterans and child outcomes, found that 18.1% of children of veterans in America, live with a parent who is disabled (Lakdawala & Bharadwaj, 2022).  These children, ages 5-18, who live with a disabled veteran parent, were found to be significantly worse off along schooling and health dimensions.  The child is 6.5% more likely to be late for grade, and 48% more likely to develop cognitive difficulties, when compared to a child whose parent(s) have no disability.  The study found that children whose parent(s) suffer from a severe disability are likely to enter adulthood with a significant disadvantage (Lakdawala & Bharadwaj, 2022).

Children of service members returning from a combat deployment are affected by the service member’s PTSD symptoms and are often aware of the service member’s exposure to trauma during the combat deployment.  The reactive-coercive and withdrawal-avoidant responses from the military member are likely to cause negative reactions and responses from the children who are also trying to adapt to the military member’s return and adjustment to post-deployment life (Brockman et al, 2016).  Many of the men and women in the United States Armed Forces deploy anywhere from six months to eighteen months.  During their absence, life at home continues and the family must learn to adapt to a parent being absent.  When the parent returns from deployment, it takes work to reintegrate themselves back into the home.  A parent returning from deployment cannot quickly reassume their role within the home but must ease themselves into their role.  When the parent is struggling with reintegration as well as combat experiences, this makes the process much harder for them and the family.  The veteran’s child(ren) want their parent to quickly assume the role they had before deployment, but the veteran is struggling with internal things they are unable to explain to the child(ren). 

A 2016 study found that veteran parents with PTSD struggle in their role as parents.  The study found that the symptoms associated with PTSD such as avoidance, alienation, numbing and aggressive behavior, had a negative influence on how the parent(s) perceived their own competencies as parents.  Veterans with PTSD were found to view their own parenting skills in a negative way.  Additionally, feelings of alienation, detachment from their families, and not feeling worthy of love, complicated the veteran’s parenting practices (Pollmann, 2022).  This scenario is common with almost every veteran returning from combat and has the ability to wreak havoc on the home, the child(ren), and the spouse.

Over 53,000 United States service members have been injured since combat operations throughout the Middle East that began in 2001.  A large number of military spouses or significant others have been affected by the combat-related injuries of the returning service member.  When compared to spouses of healthy veterans, spouses of veterans with PTSD exhibited much higher levels of psychiatric symptoms like depression and anxiety, as well as fatigue, sleep disturbances, and headaches (Cozza et al, 2022). 

PTSD often negatively affects partnerships between the veteran and their spouse.  Studies have shown PTSD has often caused complications in trust and intimacy between veterans and their spouses.  A 2017 study found that living with a partner with PTSD was described as a life-changing event that included feelings of unpreparedness and emotional pain.  The study found that partners of veterans who suffered from PTSD reported relationship distress, dysfunction in their marriage, and lower levels of family satisfaction (Pollmann, 2022).

  The change in a service member’s mental and emotional health, often as a result from a combat-related injury such as PTSD, equally disturbs and results in his or her spouse’s emotional and mental state.  For the veteran with PTSD continuing to live in a world of trauma, they tend to lose interest in activities they once found desirable.  The veteran’s nervousness, irritability, difficulties sleeping, concentrating, and remembering, have a direct and significant impact on their marital relationship.  Anger, hostility, emotional numbness, withdrawal, and detachment are some of the symptoms that affect the veteran’s ability to maintain intimate and sexual relations with their spouse.  This often leads to a sense of rejection and frustration with the spouse (Arzi, Solomon et al, 2000).

Thus far, this paper has discussed PTSD and the effects it has on family dynamics, marriage, relationships, and parenting.  There are indeed many negative effects to PTSD that extend beyond the veteran.  PTSD can be treated with counseling, medication, and coping skills can be developed.  PTSD isn’t typically something, once treated, that will last an entire lifetime.  There are service-connected disabilities however that will affect the veteran and their families for the entire lifetime of the veteran.  Some of these disabilities are more severe than others, and some of them, like PTSD, cannot always be seen when one is looking at the veteran. 

One of these disabilities that can sometimes be invisible to many is Multiple Sclerosis (MS).  Since combat began in the Middle East following the terrorist attacks on September 11, 2001, there has been an alarming increase in veterans being diagnosed with Multiple Sclerosis.  There are many things believed to be attributed to the rise in MS cases throughout the ranks of the military, such as burn pit exposure, Anthrax vaccinations, and possibly even the repeated exposure to explosions within close proximity to the veteran. 

Multiple Sclerosis is a chronic neurological disease that affects the central nervous system and cannot be cured.  Early treatment can delay the progression of the disease and delay impairment.  Symptoms of MS include impaired vision and eye function, sensory symptoms, impaired motor function, sexual dysfunction, impaired bladder function, fatigue, cognitive impairment, depression, anxiety, numbness in extremities, and memory or processing impairment (Stahl & Duner, 2022).  Long-term diseases and disabilities, like PTSD and the effects previously mentioned, can have effects on families, relationships, dynamics, and parenting. 

A recent study focusing on children’s relationships with their parents and peers where one parent suffers from MS, compared to children with two healthy parents, was conducted and found to have astonishing results.  Children from families with a parent who has MS differed significantly from children with two healthy parents when it came to trust, communication, and feelings of alienation.  Another study yielded some positive results however and found that children with a parent who has MS were more empathetic and grown-up than their peers.  The study reported greater sensitivity and understanding of the needs of others (Anassontzi, Christopoulos et al, 2021).

While both PTSD and MS, as well as many other combat-related injuries, may have negative short-term and long-term effects on the family of the combat veteran, there is a lot the family members of the veteran can do to help them heal emotionally, mentally, and to strengthen their relationship despite the service-connected disability.

Six strategies recommended to help families cope and deal with long-term combat-related disabilities include:  maintaining a physically safe and structured environment, engaging required community resources, developing and sharing knowledge within and outside of the family that builds shared understanding, building a positive emotionally safe and warm family environment, mastering and modeling important interpersonal skills, including  problem solving and conflict resolution, and maintaining a vision of hope and future optimism for the family (Gewirtz & Youssef, 2016).  One of the most difficult things mentioned earlier in regard to PTSD, was the veteran’s perception of themselves and their parenting, in a negative way.  Due to their disability, the veteran is already in a place emotionally and mentally where they feel they have failed their families.  They see the emotional disconnect they have with their spouse and children, desire to have that connection they once had or know they should have, but don’t really comprehend how to get past the point where they are currently and have that deep emotional connection.  They feel stuck in the present.  When the family is willing to come alongside the veteran, learn about what is affecting them, and shares that knowledge with others in the family or their social circle, this benefits the veteran by creating a safe environment for them to operate in.  They no longer feel as though they are fighting the battle alone.  The men and women who once stood to their left and right in uniform, are now replaced with their spouse, children, and social network.  They feel as though someone has their back and will fight alongside them as they seek to heal mentally and emotionally.

It was mentioned earlier that despite the devastating effects that PTSD and other service-connected disabilities can cause on both the veteran and the families who deal with them on a daily basis, there is strength and freedom found through Jesus Christ.  Paul wrote in 1 Corinthians 12:9, “And He said to me, ‘My grace is sufficient for you, for power is perfected in weakness.’  Most gladly, therefore, I will rather boast in my weaknesses, so that the power of Christ may dwell in me (Steadfast Bibles, 2021).  Paul later writes in 2 Corinthians 3:17, “Now the Lord is the Spirit, and where the Spirit of the Lord is, there is freedom (Steadfast Bibles, 2021).  While the freedom being referred to here is a freedom from the bondage of sin, it can also be applied to anything that binds individuals and keeps them from living the life Christ planned for them.  Bad things happen in life.  Men and women go off to war because that is what they are told to do, and some of these men and women return with disabilities and diseases that will both temporarily and forever impact their lives and the lives of those around them here on earth.  But believers in Christ must turn to Scripture and recall the words of Jesus in Matthew 11:28, “Come to Me, all who are weary and heavy-laden, and I will give you rest” (Steadfast Bibles, 2021). 

The power of God is perfected in the weakness of humanity.  The grace of Christ is sufficient for yesterday, today, and tomorrow.  His grace is a well that will not run dry and a river that flows into the lives of every single individual who puts their trust in Him and seeks Him.  He doesn’t withhold His grace from those who humbly approach Him.  That is where counseling must begin and that is where Christian counselors must seek to lead their clients to:  the abundant well of grace from which they can drink freely from.  Military service-connected disabilities impact not only the veteran returning from a combat deployment, but have lasting impacts on family dynamics, the veteran’s children, and their marriages and relationships.  Despite the short and long-term challenges of these disabilities, there is freedom in Christ and dealing with the challenges.  To God alone be the glory!

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References

Anassontzi, S., Tsiantis, J., & Christopoulos, A. L. (2001, December 27). Parental multiple sclerosis: Child-parent and child –peer attachment. Parental multiple sclerosis: child-parent and child –peer attachment. https://www.tandfonline.com/doi/full/10.1080/17450128.2021.2015032

Brockman, C., Snyder, J., Gewirtz, A., Gird, S. R., Quattlebaum, J., Schmidt, N., Pauldine, M. R., Elish, K., Schrepferman, L., Hayes, C., Zettle, R., & DeGarmo, D. (2016). Relationship of service members’ deployment trauma, PTSD symptoms, and experiential avoidance to postdeployment family reengagement. Journal of Family Psychology, 30(1), 52–62. https://doi.org/10.1037/fam0000152

Cozza, S. J., Ogle, C. M., Fisher, J. E., Zhou, J., Zuleta, R. F., Fullerton, C. S., & Ursano, R. J. (2022). The effect of war injury and combat deployment on military wives’ mental health symptoms. Depression and Anxiety, 39, 686–694. https://doi.org/10.1002/da.23274

Gewirtz, A. H., & Youssef, A. M. (Eds.). (2016). Parenting and children’s resilience in military families. Springer International Publishing. https://doi.org/10.1007/978-3-319-12556-5

Jeanette Bonde Pollmann a b, a, b, Highlights•Is based on interviews with veteran families living with PTSD.•Examines veteran parents’ support-seeking strategies and practices.•Explores “parental epiphanies” in negotiating access to social support.•Offers insight into families’ use of form, & AbstractPost-deployment posttraumatic stress disorder (PTSD) does not merely affect veterans. A growing body of literature highlights the detrimental impact of veteran PTSD on entire families. One area less studied pertains to how PTSD affects veterans’ p. (2022, March 10). “My children do not deserve it”: Understanding how epiphanies instigate support-seeking practices among veteran families living with PTSD in Denmark. SSM – Mental Health. https://www.sciencedirect.com/science/article/pii/S2666560322000317

Lakdawala, L. K., & Bharadwaj, P. (2022, November 9). The relationship between parental disability and child outcomes: Evidence from veteran families. PloS one. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9645595/

Legacy standard bible. (2021a). . Steadfast Bibles, a division of Three Sixteen Publishing.

N. Ben Arzi, Z. Solomon, R. Dekel (2000) Secondary traumatization among wives of PTSD and post-concussion casualties: distress, caregiver burden and psychological separation, Brain Injury, 14:8, 725-736, DOI: 10.1080/026990500413759

Ståhl, D., Bjereld, Y., &  Dunér, A. (2022, February 24). Disabled in society – A scoping review on persons living with multiple sclerosis and disability. Journal of multidisciplinary healthcare. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884705/

Zerach, G., & Gordon-Shalev, T. (2023). Distress tolerance, family cohesion and adaptability, and posttraumatic stress symptoms among combat veterans and their parents. Family Relations, 1–22. https://doi.org/10.1111/fare.12861