A panel of guests discusses what post-traumatic stress disorder (PTSD) is, how it impacts individuals and families, and where they can turn for help. (Part 1 of 2)
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John Fuller: Well, it's very likely that you have a family member of a relative or someone you know who is serving or has served in the military. Perhaps they're even a veteran of war. Well, for those veterans, there are visible wounds and invisible that cannot be overlooked and that's what we'll discuss on today's "Focus on the Family."
Our host is Focus president and author, Jim Daly and I'm John Fuller and Jim, this is a very complex subject to get our arms wrapped around.
Jim Daly: John, we're going to try to tackle it and I'm in some ways excited to do this, because I think it's a very important topic that we're gonna talk about today. It impacts literally hundreds of thousands of people in our military and we'll touch on even folks outside the military that this issues touches upon.
And what we're talking about is PTSD, Post-Traumatic Stress Disorder. And so many people in the military [are] impacted by that, John. I felt it would be important for us to inform people about it for two reasons: one, so that we can pray for those in the military and also, so we might be able to help.
That's one of the key things and it's just not Focus on the Family, the staff here, but each of you, what can you do in your neighborhood to help somebody dealing with this very difficult issue?
John: Well, we have a panel of military guests and experts here to help us talk about this. But before we get to them, a couple of things. First, let me advise parents and I hope this is obvious, but we're gonna be talking about war. And so, this isn't a program suitable for young children.
And then, to help set the topic up for you, we wanted to play an audio clip from Lieutenant Colonel Oliver North. He's a combat veteran. He's spent years on the battlefield with our troops in Iraq and Afghanistan as a FOX News correspondent. And he's the author of the book, American Heroes. Here's how Colonel North describes this problem of combat PTSD.
Lieutenant Colonel Oliver North: Those who've been injured in this way in many cases, wouldn't have survived in another war. And so, you have youngsters today with multiple amputations and chronic issues of TBI, Traumatic Brain Injury, very serious issues of PTSD [Post Traumatic Stress Disorder]. And some of my colleagues I don't think understand the nature of something like PTSD. Post-traumatic stress happens to everybody. Whether it becomes a disorder or not often is the consequence of the way it's treated or how severe the injury that caused it is.
The reality is, that these youngsters, unlike my dad for example, who was in World War II, left home in 1942; didn't come home until 1945. But the average length of time in combat, actual physical combat in either the European Theater or the Pacific Theater was about 6 1/2 months.
There's youngsters in the 3rd Infantry Division in the United States Army who enlisted for a 48-month enlistment, extended out to 60 months, who will have spent 45 months in combat--15-month tours. Repeatedly out for 15 months, back for a year, out for 15 months. And they're not going to the ... some rest and recuperation, you know, operation. They're going into mortal combat.
And so, these youngsters--brightest, best-educated, trained, well-equipped military force in world history--have nonetheless seen more combat than anybody else in American history and even world history, even the Hoplites, marching with Alexander didn't see as much combat as these kids.
End of Clip
Jim: Well, that really does help us to better understand and appreciate better what those in our Armed Forces are going through, John. And let's introduce our guests now, so we can put a face to this problem. We are honored to have Major General Bob Dees here. General Dees is retired from the Army, after a long and distinguished career. He's been highly decorated. He's received the Distinguished Service Medal multiple times, among other achievements. He was the commander of the U.S. Israeli Combined Task Force for missile defense and a former Army Ranger. General Dees, thanks for being with us today.
Bob: Great to be here, Jim and John. Good to be with Focus on the Family.
John: Let me introduce our other guests here. Dr. LuAnn Callaway is from Georgia and she holds a Ph.D. in Psychology and a Master of Arts in Marriage and Family Counseling. She's been counseling for 30 years and for the past 20, has been working with victims of trauma.
Also Retired Major Robert Nuttall is here with us, along with his wife, Amy. And he served in the Army originally and then, retired from the Army Reserves in 2005 and saw combat in Iraq. And he and Amy have four children and they live in Texas. And we're just so grateful to all of you for joining us today.
Jim: Let me give some scope to this, General Dees. I heard something the other day that really caught my attention. The Afghan war is now the longest-running war in U.S. history. You know, I think for most of us, when we think of World War II or even the Vietnam War, you think of those are the big wars. There's a lot of impact happening to our young men and women, isn't there?
Bob Dees: Jim, that's certainly true. It is the longest. It's the largest deployment of Guard and Reserve forces, as well as our active duty forces in our nation's history. And some of our troops are on their third and fourth, fifth, sixth deployments.
Jim: Let's talk about that for a minute. Describe for us PTSD [Post-Traumatic Stress Disorder], kind of what is it? And most of us won't know, so please be very elementary for us.
Bob: Sure. I would describe PTSD as a normal reaction to abnormal events in one's life.
Jim: Explain that, a normal reaction.
Bob: When one sees carnage, when one sees death, when one is traumatized in various ways and PTSD occurs in the civilian populace, as well as the military combat setting, when it occurs, it causes impressions in the mind that set a chain of events in place which causes re-experiencing of the event, which causes the inability to sleep and nightmares and intrusive thoughts. And over time, it becomes dysfunctional in your life. It often even controls your life. We talk about the hidden wounds of war.
Bob: The hidden wounds of the war are, you know, even more tragic at times than the visible--
Bob: --wounds of war.
Jim: Give us some scope of the military troops. How many within the military would be suffering from PTSD?
Bob: We're talking about 20 percent of our returning forces that are generally diagnosed with PTSD or with other symptoms of depression, serious depression.
Jim: Would that be somewhere in the 50, 100, 200,000 range now?
Bob: We're talkin' about hundreds of thousands, probably 300,000 is a statistic that is--
Jim: Three hundred thousand.
Bob: --best used right now, that are active cases of post-traumatic stress of our nation's military over these recent conflicts.
Jim: Dr. Callaway, with PTSD, what causes it? I mean, I'm sure there are some listening that think, "Well, you just kinda gotta get through it and get over it. War is not a good place and it's normal to have nightmares and other things." But it's not, is it?
LuAnn Callaway: It's so complicated, because our soldiers are looking into the face of evil. And they really aren't expecting to see the inhumanity to man. It contradicts their values, their beliefs, their images, their realities of what life is supposed to be like. Instead, they're looking square in the face of people who will use human shields and that will do atrocities that we can't even imagine.
Jim: And that sets in then. They're in these horrific experiences, 18-, 19-year-old young men and perhaps even a young woman now.
Jim: They're seeing combat, as well in different ways.
LuAnn: That's right.
Jim: But they'll be on the battlefront. There'll be a fire fight. There'll be carnage that is difficult to describe--
Jim: -- bodies ripped apart and--
Jim: --other things. Those images are long lasting. Is that what causes that PTSD? And how does it manifest itself?
LuAnn: Any time we have a contradiction, those memories don't file well in our brains. There's a part of the brain that actually shrinks under stress. There's a part of the brain that lodges horrific memories. And they're not able on their own to move those memories into places of storage. They're right up front in the prefrontal cortex, right in their forehead. And they haven't been able to move them on their own.
Jim: How does someone cope with that? I mean, you're having night sweats or you're having nightmares or you're being aggressive with your family? Or do you pull back? What are some of the kind[s] of the symptoms of PTSD?
LuAnn: Generally the symptoms don't match the "citizen" PTSD that we're used to. There's a Diagnostic and Statistical Manual for Mental Health that describes PTSD as being someone who needs a lot of comfort or they like things quiet.
And when our soldiers come back, they're full of adrenaline. They've been living on adrenaline for a year. And so, when they come back, everything is so slow to them. So, it's very common for a soldier to come back and buy one of these motorcycles that, you know--
Jim: Speed rocket served.
LuAnn: --a speed rocket or something like that. In fact, our returning soldiers are five times more likely to have a fatal accident--
LuAnn: --on one of those, than the citizen would.
Jim: Is it a reckless nature or a disregard for life? They've seen such carnage that they don't even ... maybe sometimes don't even believe they should be alive? I mean, that--
LuAnn: t's true that--
Jim: --it all doesn't make sense--
LuAnn: --they don't often feel like that they deserve to be alive.
Jim: So, they take greater risks?
LuAnn: They take greater--
Jim: Is that what ... ?
LuAnn: --risks. They like the feeling of adrenaline. Adrenaline makes them feel alive again. And so, they don't act like the citizen that's been held up at gun point in a convenience store. They act in a way that, if counselors aren't careful, they may miss their symptoms. They like loud music and they isolate themselves. Whereas the citizen with PTSD wants comfort, the soldier doesn't want comfort.
Jim: So, the non-military PTSD, you want calm; you want quiet.
Jim: You want to be in quiet. Military PTSD, you want to keep that adrenaline high.
LuAnn: Adrenaline going, uh-hm.
Jim: You want to put yourself at risk; it's the combat situation, because you've become addicted in some ways to that?
LuAnn: To the adrenaline, yes.
John: This is "Focus on the Family" with Jim Daly. I'm John Fuller and our guests today to talk about PTSD are Major General Bob Dees, Dr. LuAnn Callaway and Robert Nuttall and his wife, Amy. And Dr. Callaway, I'm just wondering, compared to previous wars, is the incidence and intensity of PTSD that we're seeing today greater than say, as you mentioned, Jim in the Vietnam War or perhaps even back in World War II or World War I?
LuAnn: We've always had some form of PTSD or they called it "shell shock" when my grandfather--
LuAnn: --served in the second World War. They've called it "the Soldier's Heart" when it was in the Civil War and "Combat Stress" during the Vietnam War. But we are seeing a greater intensity with this war; I don't think it's just because it's lasted longer, but they're seeing more things. They're more hands on with who we're fighting. And so, because of that, they have these memories that they just don't know what to do with.
Bob: John, if I might add the Vietnam generation and Jim, just has a tremendous gash in the national psyche still.
Bob: And so, the Vietnam generation had very serious post-traumatic stress. In fact, that was why it was defined in psychological--
Bob: --channels because of all the symptoms we were seeing coming out of that war.
Jim: General Dees, I was gonna ask a question similar to that, which within the military, is it seen as a weakness to come forward with this? If you're struggling at home, you're having these nightmares, you're having these traumatic instances where you're having flashbacks and other things, how difficult is it to say, "I need help?"
Bob: This is what is often called "the stigma," the stigma of reporting that you need help, because your career might be jeopardized--
Bob: --because your security clearance may not be renewed. And the military is doing many things to reduce that stigma and yet, it's a cultural issue that's gonna take a lot of time, so that soldiers, sailors, airmen and marines know that they can demonstrate they have this issue and they can seek help without stigma or without prejudice to their career or any other part of their life.
Jim: Hm. Robert and Amy, I think this is the place where we need that personal story of how you're impacted and Robert, when you were in Iraq, you served for many years in the military, but when you were in Iraq specifically, a year of combat, you were the company commander. You saw a lot of action. You returned home and tell us firsthand, what began to happen for you?
Robert Nuttall: Well, the problem is, is the Army does the greatest job in the world in programming you to go. I was very confident in my abilities to lead troops in combat. The problem is, when you come home, there's no deprogramming.
Robert: What do you do when you see these soldiers blown up in an IED [Improvised Explosive Device] and you see all the carnage and the bodies and the blood? You know, there's no deprogramming for that.
Robert: There's no training that I received to deal with those memories and issues. They took my gun away. That was the only thing I had to defend myself over there. So, essentially, I was defenseless. And what I simply did is, bein' somewhat of an introvert, I think we're all predisposed the way post-traumatic stress manifests itself.
For me, being an introvert, I just wanted to self-isolate myself. I pushed the whole world out--my wife, my family. Soldiers who are inclined to violence, they seek violence. Soldiers who are inclined to alcohol, you know, they self-medicate with alcohol. Soldiers that are inclined to drug use, self-medicate with drug use--
Jim: So, those things ...
Robert: --and prescription drugs--
Robert: --are probably the No. 1 abused drug right now in the Army.
Robert: So for me, I just went back in my foxhole and I pushed the world out. And I didn't want to let anybody in, not even my wife or family, because what I was going through, you know, I was in the pit, if we want to use what David calls it. I was about as low as you can go.
Jim: How did that manifest in the family for you? You just withdrew; you weren't speaking to Amy? Or what did it feel like?
Robert: Well, I just wanted to push the whole world away. I didn't want to be involved in my marriage. You know, I didn't even want to play ball with my son. I didn't want to go to any volleyball games of my girls. You know, I just wanted to be alone and try to fight this battle in my mind by myself. And I was losing.
Robert: I was losing really bad to a point where my wife, Amy said, "You need to get some help."
John: Reverend, what was the nature of the battle?
Robert: Well, I couldn't sleep. You know, people say, "Well, Robert, when'd you get back from Iraq?" And I'd say, "Well, I got back last night, because I dreamt about it all night long."
Robert: You know, I was extremely anxious. You go into a restaurant and I had to put my back to the wall, because I gotta see everybody in the room. I gotta see their hands. That's how hyper vigilant you are.
Jim: That's how you stay alive.
Robert: That's how you stay alive. I've gotta watch people. I dealt with crowds mostly over there in Iraq in the cities, pushin' people back, you know.
John: So the war never left you.
Robert: No, no. Flashbacks, drivin' on the freeways in Houston. We were havin' IEDs bein' blown up over there. They're bein' put on the guard rails. General Odierno cut down every guard rail in the country of Iraq. You know, you don't forget those things driving in the city, little shopping bags and stuff. I'm swerving on the freeway. You know, that could be a bomb underneath there.
You know, don't put me in a July 4th celebration. I just can't handle it, the big crowds. I can't handle it. And then, the flashbacks. You never know when they're gonna occur. I bought a palm tree for my backyard and I went to dig the hole. And my wife sees me in the backyard crying. She said, "What's goin' on?" I said, "Well, the last time I had a shovel, I was scrapin' bodies out of a vehicle in Iraq."
Robert: Who would've thought? It was just a shovel. I went to dig a hole.
Robert: How do you prepare yourself for that?
Jim: It's just constantly with you.
Robert: It's just constantly with you.
Jim: Amy, as Robert's wife, he comes back. You're tryin' to just pick up from where you left off. He's just been gone for perhaps a year. Let's just keep movin'. But it didn't turn out that way.
Amy Nuttall: Right. I think that was the hardest part especially because we were in the Reserves and maybe you're not on a base or you're not as in touch with how that works when they come home. But I, 100 percent, expected Robert to come home the same person that he left. And it never once crossed my mind that he wouldn't.
I guess you always think of, maybe he'll come home hurt on the outside, but never on the inside. And um ... it was a long time before we even heard what PTSD was. So, we've been dealing with it for six years and it's not an easy subject. After six years, it's still hard to deal with in our family and it's still frustrating on both his side and my side.
And it puts a lot of stress on a marriage and I think what we saw while he was over in Iraq, marriages failed right and left. If your marriage was weak going into a deployment, the chances of it surviving were very slim. Marriages that were literally strong, it put a ton of stress on 'em, especially when you come home and you expect somebody to come home the same way that they left. And that wasn't the case.
Jim: That to me, is profound because I think so many of us ... I didn't serve in the military. My brother did. But you think of just picking up where you leave off. It rarely happens like that. And there was an event for you, I think both of you, even after you returned from Iraq. It was not a military situation. Talk about the accident that really changed you.
Robert: Well, when I came home from Iraq, you know, every unit would have a welcoming home ceremony. And we went to the welcoming home ceremony and the big wigs come out and they pin all the medals on your chest and so forth.
And me and my wife and my daughter, Samantha were driving home and we get into the city limits of Houston and a drunk driver goin' well over 100 miles an hour, hits my vehicle.
Robert: And we start flipping and I have a serious head injury and my daughter fractures her neck at the C4-C5 and--
Robert: --he dies on impact. And my wife, Amy, she rode it out conscious the whole way. So--
Robert: --two life flights to our level-four trauma center there in Houston. And you know, [we] don't know if I'm gonna make it. She calls my dad and says, "You better get to the hospital. Robert may die."
And that was just like a force multiplier in what was already goin' on in my life, as far as depression and post-traumatic stress.
Jim: How long had you been back from war when that accident happened?
Robert: Oh, maybe just a couple months.
Jim: A couple of months, so--
Jim: --I mean, all of that, what you were just describing how you drive down the freeways in Houston, that was all playing out. And then here this man basically, comes right at ya, 100 miles an hour.
Robert: Right. I mean, in many ways, it was very much a blessing in disguise.
Jim: Why? Why do you say that?
Robert: Well, when I was treated after the accident and thank God I was on active duty when this happened, is the neuropsychologist, you know, as they're askin' me questions and going through my evaluation, you know, I just began to break down at certain questions crying. And she looks at me and she goes, "Do you know what post-traumatic stress is?" And I said, "No." She goes, "Well, you have serious symptoms of post-traumatic stress" and I didn't even know that.
And so, in a way, that's how I was diagnosed. And so, I see that as a blessing. And it really started a season of healing and hope in my life, first being diagnosed.
Jim: Hm. Amy, you stayed conscious through the accident. What is going through a wife's mind, a mother's mind? Your daughter was ejected--
Jim: --from the vehicle, right?
Amy: Uh-hm. It was a hard road, you know, to have Robert come home and we were so happy that he came home and what we thought on the outside was normal and fine. And then, to be hit by a drunk driver and have our entire worlds just turned upside down.
Neither of us heard the gentleman who hit us. It's not like he was screeching through traffic and hit his brakes right before he hit us. As we weren't tensed up when we were hit. So, we were hit. Our vehicle rolled. As we were hanging upside down in the vehicle and I looked over at Robert and I thought he was dead. And I said, "Robert, Robert" and there was no response.
Amy: And so I said, "We gotta get out of this car. The car's gonna explode." I mean, it was bubbling. It was making all these noises and so, I finally got unbuckled and flipped upside down and crawled out the window and went to look back in the car for my daughter and she was nowhere to be found.
Your first initial reaction is, "Oh, my gosh! She's under the car." And so, you know, you're looking and you're disoriented and I looked back and you could see the gentleman who hit us and he was also on the road. He had been ejected, as well. And then, really, really far back on the fast lane of traffic was my daughter laying there. And so, I just went to her.
And in the meantime with me going to her, people went and got Robert out of the car and Samantha, I just sat on the road and I actually took my shirt off and she was bleeding profusely from her head and just held her head and just held her completely straight, 'cause she was obviously severely injured. And in the process, Robert ... the entire back of his head was removed. When we flipped upside down, the car actually landed on the roof and drug about 60 feet and Robert's head was pinned between the steering wheel and the pavement.
Amy: And so, it removed the entire back side of his head. And so, there was [sic] many, many angels there that day. Samantha, first of all should have never lived, leaving a vehicle in Houston traffic, traveling across three lanes of traffic in the wrong direction that the vehicle went. You know, usually you travel in the same direction that the vehicle was rolling. She traveled in a completely different direction.
Jim: Just the force of the impact.
Amy: Yeah, I believe that an angel moved her.
Amy: I don't believe that there's any other way that she could've survived that accident. People today don't do what they did on the side of that road. There was just ... you know, people sit [sic] on each side of him and prayed. I mean, it was a really life-changing moment for us.
Jim: Samantha, just an update, how is she today?
Amy: Well, Samantha is very, very blessed. We had a leading neurologist in Houston and she is the one half of one percent that walks away from that accident--
Amy: --because she is able to walk.
Amy: Most people are paralyzed for life. She's very blessed.
Jim: And Robert you're feeling pretty well recovered or ...
Robert: I have my days, but there again, it was a blessing. You know, the military retired me because of my head injuries. And as I discerned what I was gonna do with the rest of my life, I'm only a 34-year-old man, you know, I heard God's whisper. I heard that little nudge in my heart that God said, "I want you to serve Me."
Robert: And you know, I went to the VA and I said, "Well, I think God's callin' me to seminary." And they said, "Well, Robert, you have brain damage. You've got memory problems, cognitive issues. You've got all sorts of issues goin' on in your head. You can't be successful."
Jim: Robert, you know what? This is a horrible place to stop, John, but we need to end day one and we're just gettin' rollin'. So, we need, if you guys are willing, to hold on and let's come back next time and hear how the Lord has intervened in your life.
LuAnn: All right. That--
LuAnn: --sounds incredible.
Bob: Thank you--
Amy: Thank you.
John: Oh, Jim, you're right; it's really difficult to stop right here, but time dictates that we do so. I do hope you'll be with us next time. It's obvious that God has done some remarkable work in Robert and Amy's lives and certainly, we're appreciative to them and to Dr. Callaway and General Dees for joining us. This is an important program. If you didn't hear the whole discussion or if you can't be with us next time, please go online, listen or get the CD or you can get the download. And please tell a friend, as well. There's such valuable information here and this is just something that we have to know more about. And you can help others by letting them know about the radio program.
Now it might be that what we've talked about today has really touched a nerve. It's something that you're feeling personally or perhaps a close friend or family member is struggling. Please know that Focus on the Family stands ready to help you. We have caring counselors on staff and they can provide an initial consultation as a starting point to wellness.
Now tens of thousands of folks are helped every year. They have serious needs. They contact us and we get them on that road to recovery, oftentimes referring them to trusted counselors located around the country. Now we can only do this because of your generous donations to this not-for-profit ministry. So, if you're in a good place, let me ask you to pray about and then join us by becoming a Friend of the Family member. That's an ongoing donation program that's very easy to set up and we can tell you more when you call 800, the letter A and the word FAMILY; 800-232-6459.
Our program was provided by Focus on the Family and on behalf of Jim Daly and the entire team, thanks for listening. I'm John Fuller, inviting you back next time, when we'll continue talking with our panel about PTSD, and offer more trusted advice to help you and your family thrive.
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Bob DeesView Bio
Maj. General Bob Dees retired from the U.S. Army in 2003 after 31 years of distinguished service. He was an Army Ranger and served in a wide variety of command and staff positions. Dees is currently Associate Vice President for Military Outreach and Director of the Institute for Military Resilience at Liberty University.
Robert NuttallView Bio
Retired Maj. Robert Nuttall served in the U.S. Army for three years and then transitioned to the U.S. Army Reserves where he served for nine years. He is a combat veteran of the war in Iraq. Robert and his wife, Amy, have four children and reside in Texas.
LuAnn CallawayView Bio
LuAnn Callaway holds a Ph.D. in psychology and a master's in marriage and family counseling. For the last 20 years of her three-decade counseling career, she has specialized in counseling trauma victims, including those who struggle specifically with combat trauma. Dr. Callaway and her husband, Sid, have a son who has served in the U.S. Army.