URJHS Volume 7

URC

Coming Home: A Qualitative Study of the Impact of
Military Deployments to Iraq and Afghanistan on Relationship Satisfaction

Theresa Doyle and Lizette Strader
Erin Sanders-Hahs**
Briana S. Nelson Goff*
Kansas State University


Abstract

Research traditionally has focused on the development of symptoms in those who directly experienced trauma but overlooked the impact of trauma on the families of victims. In recent years, researchers and clinicians have begun to examine how individual exposure to traumatic events, like war trauma, affects the spouses/partners of trauma survivors. The current study reports qualitative data from 25 participants, including U.S. Army soldiers who recently returned from a military deployment to Iraq (Operation Iraqi Freedom) or Afghanistan (Operation Enduring Freedom) and their spouses/partners. The results indicate themes of Posttraumatic Stress, Positive Relationship Adjustment, Implicit Relationship Adjustment, Negative Impact on the Relationship, Omission of Information, Trauma Recognition in Self, and Trauma Recognition in the Other Partner. Areas for future research also are identified related to military trauma in couples.


Literature Review

Trauma and Traumatic Stress

Having a basic knowledge of trauma is necessary for understanding the effects of soldier Posttraumatic Stress Disorder (PTSD; American Psychiatric Association [APA], 2000), as a result of the war deployments in Iraq and Afghanistan, on couple relationships. Most of the traumatic stress literature includes participants who meet the criteria for a diagnosis of PTSD, which includes a minority of people exposed to traumatic events (APA, 2000). Currently in the traumatic stress field, the definition of trauma almost exclusively encompasses the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR; APA, 2000) criteria for PTSD; thus, trauma has become synonymous with PTSD. However, some in the field have challenged this definition, suggesting an alternative model beyond the DSM-IV-TR description of trauma (Brewin, Carlson, Creamer, & Shalev, 2005; Carlson & Dalenberg, 2000; Whiffen & Oliver, 2004). Shalev (2005) indicated that a stressful event becomes traumatic when it is emotionally and personally meaningful, cognitively incongruous, and when it affects human bonds and networks, suggesting that trauma affects humans in a contextual manner.

Trauma can result from an injury, event, or situation that causes an emotional wound to an individual. Traumatic events include: war/terrorist attacks, sexual abuse/assault, physical abuse/assault, severe accidents/deaths, natural disasters, and other overwhelming events. These events can create significant lasting damage and distress to the psychological development of a person.

The Impact of Trauma on the Individual

In order to understand this research, it is necessary to have an understanding of Posttraumatic Stress Disorder (PTSD; APA, 2000). According to the DSM-IV-TR (APA, 2000):

The essential feature of [PTSD] is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). The person’s response to the event must involve intense fear, helplessness, or horror…(Criterion A2) (p. 424).

Soldiers who have been deployed are typically exposed to more of these types of events than civilians. Therefore, it is important to be able to identify the symptoms of PTSD, especially in soldiers, in order to provide treatment to overcome this disorder.

The DSM-IV-TR (APA, 2000) lists all the symptoms necessary to make a diagnosis of PTSD. “The characteristic symptoms resulting from the exposure to the extreme trauma include persistent re-experiencing of the traumatic event (Criterion B), persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (Criterion C), and persistent symptoms of increased arousal (Criterion D)” (APA, 2000, p. 424). In a soldier who has returned from deployment, this could be demonstrated in how he relates to his spouse and his communication about what happened during his deployment. Increased arousal may affect sleeping, such as having nightmares and being physically violent during sleep. These symptoms are just a few examples of what soldiers may experience after a deployment.

The Impact of Trauma on the Spouse/Partner

There is much research to show how PTSD affects the primary trauma survivor, including war veterans. The literature on the impact on the spouse/significant other is increasing, but remains much less than the individual traumatic stress literature. The amount of stress that is placed on the non-deployed spouse is greater when the deployed spouse returns with PTSD. According to Arzi, Solomon, and Dekel (2000):

Spouses of the victims of both disorders [PTSD and Combat Stress Reaction] bear a heavy caregiver burden. Not only do they have to take care of their highly distressed and not fully functioning partners, but, in many cases, the entire responsibility for maintaining the family, including raising the children, doing the household chores and errands, and earning a living, falls on their shoulders (p. 726).

Spouses at home during the deployment have had to adjust to their changing role in the household. Their responsibilities have already increased, so when soldiers return home with war trauma or PTSD symptoms, increasing the responsibility again causes much added stress. This added stress can have a profound effect on the couple’s adjustment, as well as their communication and intimacy.

Secondary traumatization is a concept that needs to be taken into account when understanding PTSD. When a person comes into contact with another person who has had a potentially traumatic experience, s/he has the chance of becoming traumatized as well. This may be especially prevalent in couples in long-term relationships, because of the closeness between the two partners. When soldiers experience trauma symptoms as a result of their war deployment, they bring their trauma memories and symptoms into their relationship with their spouse upon reentering civilian life. Arzi et al. (2000) asserted that spouses suffer from greater psychiatric symptoms, more symptoms of somatization, obsessive-compulsive problems, depression, anxiety, paranoid ideation, and psychoticism, than the controls in their study.

These symptoms are very similar to the symptoms of PTSD. Even though one spouse did not directly experience a traumatic event, in learning about that event through the primary trauma survivor, he/she may suffer from PTSD-type symptoms as well.

The Impact of Trauma on the Couple Relationship

According to Riggs, Byrne, Weathers, and Litz (1998) veterans from the Vietnam War with PSTD and their partners, “reported more relationship distress, intimacy difficulties, and problems in their relationships” (p. 96) as compared to veterans without PTSD.

PTSD-positive veterans and their partners also had taken more steps toward separation than PTSD-negative veterans and their partners. The importance of these relationship difficulties is highlighted given the potential contribution of intimate partners to the process of coping with chronic stress or psychological symptoms (Riggs et al., 1998, p. 96-97).

In dyadic relationships, such as in marriage, each partner can help or hurt the other’s coping and recovery from PTSD. In addition, “…couples in which the husband sustained PTSD reported an increase in conflict and a reduction in satisfaction and cohesion since the event” (Arzi et al., 2000, p. 734).

As a result of one partner suffering from PTSD, the other may experience a caregiver burden. Mikulincer, Florian, and Solomon (1995) give a quote from Williams that offers a way of looking at this caregiver burden: “According to Williams (1980), wives of veterans with PTSD tend to become caught in a ‘compassion trap’ in which they sacrifice too many of their own needs for the rest of the family” (p. 204). Spouses may feel the need to overcompensate for their partner suffering from PTSD.

Moreover, the availability of support from other family members may allow the division of responsibilities, and alleviate the wife’s overwhelming burdens. Without marital intimacy and family support, wives are left to cope on their own with the post-traumatic reality. This may exacerbate negative emotions and psychopathological reactions. (Mikulincer et al., 1995, p. 204)

Purpose of the Current Study

Several limitations exist in the current literature on trauma in couples, particularly war-related traumas. Much of the available empirical literature focuses predominately on individual symptoms in both primary trauma survivors (i.e., PTSD) and their partners (e.g., secondary trauma), as opposed to understanding the impact on relationship satisfaction or other components of relationship functioning in couples. Because it is a relatively new area, current research on the impact of traumatic stress symptoms on the relationship satisfaction of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) soldiers and their spouses/partners has not been conducted. The current study seeks to provide information about the impact of OIF/OEF deployments on the relationships of soldiers and their spouse/partner utilizing a qualitative research methodology.

Method

Participant Recruitment

The research described here is part of a larger study of 50 military couples extending beyond their OIF/OEF deployment experiences, including data from quantitative surveys and individual qualitative interviews with each partner. This study included results from participants in two small cities in the Midwest that neighbor Army posts in close proximity to the university where the research was conducted. Ft. Riley is a fairly large post with approximately 10,000 active duty military personnel and 12,020 family members, housing several combat units (Globalsecurity.org, 2005). Ft. Leavenworth is primarily a training facility for majors and lieutenant colonels representing all branches of the Army, with a population of approximately 5,253 military personnel and 4,613 family members (Globalsecurity.org, 2005). A “class” of approximately 1,000 officers attends this training college annually.

Participants were recruited from within the local communities through a variety of methods, including publicly posted flyers and newspaper announcements; referral from Army Family Readiness Groups, chaplains, and other local military sources; and referral by other research participants. Participants were not recruited by contacting staff or soldiers directly through the military bases. All recruitment occurred through contacts in the surrounding communities or through contacts to the researchers.

The sampling method was both purposive and convenience, in that recent deployment to OIF or OEF was a criterion for participation and couples volunteered to participate. Inclusion criteria also included the following: all study participants were 18 years of age or older, had been in their current relationship for at least one year, and denied current substance abuse or domestic violence during an initial telephone screening. Each couple that completed questionnaires and the interview process received $50 for their participation.

The research procedure was approved by the University Institutional Review Board (IRB), with assurances made to follow informed consent procedures and to protect participant privacy and confidentiality. Because the research project was not completed within the military system, nor was data collected on the military posts, military IRB approval was not included in the research procedure process.

Data collection began 8/25/04 and concluded 6/20/05. Out of 56 total couples who initially agreed to complete the study protocol, 11 cancelled or did not show for their scheduled appointment, resulting in a final total sample size of 50 couples (n = 100 total participants) with complete data.

Participant Characteristics

The total sample for the current study included 11 male soldiers and 14 female partners from the original sample of 50 couples. Participants reported a mean age of 30.76 (SD = 5.78). The age range for the participants was 20 to 43. The sample was predominantly European-American (76 percent [n = 19]). The remainder of the sample was American Indian or Alaska Native (8 percent [n = 2]), African-American, not of Hispanic origin (8 percent [n = 2]), and other (8 percent [n = 2]). Seventeen (68 percent) participants had completed high school or had some college, and 32 percent (n = 8) had a college degree or an advanced degree. Reported income levels of participants indicated that 52 percent (n = 13) had an annual net income of less than $40,000, and 48 percent (n = 12) had an annual net income of $40,000 or more. Employment status indicated that 60 percent (n = 15) of the participants worked full-time.

The participants indicated that 96 percent (n = 24) were currently married, that 68 percent (n = 17) of participants were in their first marriage, and that the average relationship length was 6.40 years (SD = 5.59; range = 5 months to 19 years; 5 months was the length of marriage for couples who had been together as a couple longer, but recently had been married).

Ninety-one percent (n = 10) of the soldiers in the sample were deployed to OIF; only one soldier was deployed to Afghanistan. For the female partners, 92.9 percent (n = 13) of their husbands were deployed to Iraq, with the other one deployed to Afghanistan. Only one female partner reported a previous deployment (not to OIF or OEF). The average length of deployment was 11.27 months (SD = 3.68), with a range between 4-18 months.

The TRECK Team

This study is part of the Trauma Research, Education, and Consultation at Kansas State University (TRECK) Team. The TRECK Team is involved with educating others about how traumatic events affect all types of people, including individuals, couples, and families. The TRECK Team has included over 90 students since 1998, which includes both graduate students and undergraduate students. The current research project focuses on the effects of war deployments on couple relationships. This research included 50 military soldiers deployed to Iraq (OIF) or Afghanistan (OEF) and their spouse/partner, who were interviewed for the current study. The TRECK Team faculty advisor and several TRECK graduate students conducted the interviews with the soldiers and their spouses/partners. These interviews were then transcribed by members of the TRECK Team and analyzed by smaller research groups. Quantitative analyses were conducted with data from the questionnaires completed by the research participants. In addition, two teams of graduate and undergraduate students conducted qualitative analyses of the transcripts.

Qualitative Analysis for the Current Project

The qualitative research team consisted of four graduate students and three undergraduate students in the Kansas State University College of Human Ecology. One graduate student with training in qualitative data analysis served as the team leader/coordinator. Between October 11, 2005 and June 21, 2006, the team met for a total of 21 qualitative analysis sessions. On average, the team held 2-3 coding sessions each month. At these research sessions, the team reviewed 1-4 interview transcripts, with each team member reporting his/her individual codes or themes identified individually. Prior to each meeting, the team members coded the individual transcripts. If the team members reached consensus with their codes, they were identified as a key theme. The group also reviewed individual codes that did not reach consensus to determine if they should be identified as themes. This method assured that the most valid codes were used for the research, because every code was either selected by the majority or determined by the team to be a unique addition to the research. Each team member marked on his/her transcripts which codes were selected for the research, while the team leader completed a master copy that was used for data entry.

After reaching consensus for the interview coding, the team utilized NUD*IST Version N6 (Richards & Richards, 2002), a software program designed for qualitative research, for purposes of data organization only. This was accomplished by uploading the full transcripts onto the program. The team leader’s master copy of the coded transcripts was used as a reference to code the uploaded transcripts on the computer. The tree nodes, which are organizational tools in the program used for separating out the themes, coincided with the themes and data found while analyzing the transcripts. The NUD*IST program then organized all the corresponding themes/tree nodes into lists.

In the preliminary study reported here, two undergraduate team members reviewed each list and selected the top 5-10 quotes from the transcripts for each theme. The data described here were the key themes and quotes identified by the two team members for their joint undergraduate research project.

Data Analysis

The analysis focused on understanding how two potentially different groups of participants would describe the impact of the deployment on their relationship. Participants were divided into two groups: High trauma symptoms (PTSD)/Low relationship satisfaction (DAS) and Low trauma symptoms (PTSD)/High relationship satisfaction (DAS). The sample identified for the current study was based on the total scores for all 100 participants (50 soldiers and 50 female partners). Numerical scores for levels of PTSD symptoms and relationship satisfaction were determined by a quantitative analysis with the following questionnaires completed by all research participants.

Trauma symptoms. The Purdue Post-Traumatic Stress Disorder Scale-Revised (PPTSD-R) (Lauterbach & Vrana, 1996) consists of 17 items that correspond to each Diagnostic and Statistical Manual for Mental Disorders, 4 th Edition, diagnostic criteria for PTSD (APA, 1994), with three subscales that reflect the three general symptom categories of Re-experiencing (4 items), Avoidance (7 items), and Arousal (6 items). The PPTSD-R items were scored from 1 (“Not at all”) to 5 (“Often”), with continuous total scores ranging from 17-85; the higher scores indicated greater PTSD symptoms. The measure, which does not provide a diagnosis or cut-off score, asks participants to indicate how often each reaction occurred during the previous month. Examples of items from the PPTSD-R include the following: Have you had upsetting dreams about the event? Did you avoid activities or situations that might remind you of the event? and Have you felt unusually distant or cut off from people? The participants’ PPTSD-R scores ranged from 17 to 78, with an average score of 36.

For this study, all 100 participants (50 soldiers and 50 female partners) were placed on a continuum for the PPTSD-R scores. The two groups were identified based on where the participants fell on that continuum of their scores. Scores equal to or over 33 (median score) were identified as “High PTSD,” while those less than or equal to 32, were placed in the “Low PTSD” group.

Relationship satisfaction. Relationship satisfaction/quality was assessed with the Dyadic Adjustment Scale ( DAS) (Spanier, 1976), which is a 32-item, variable-Likert measure assessing the quality of the relationship as perceived by both partners. Total scores range from 0-151, with higher scores indicating greater relationship satisfaction. Examples of items include the following: How often have you discussed or considered divorce, separation, or terminating your relationship; How often do you and your partner “get on each other’s nerves”; and Do you and your partner engage in outside interests together? The total range of participant DAS scores in the full sample (n=100) was from 73 to 149, with an average score of 119. The DAS has demonstrated good internal consistency on the total score (alpha = .96; Fischer & Corcoran, 2000). The DAS has adequate convergent validity correlations (.86 - .88) with the Locke-Wallace Marital Adjustment Test (LWMAT, Locke & Wallace, 1959, as cited in L’Abate & Bagarozzi, 1993), from which it was derived. Cronbach alpha estimates for the DAS were .93 for both soldiers and female partners for the full sample.

In the current study, couples with scores less than or equal to 109 were identified as “Low DAS,” while those above or equal to 126 were identified as “High DAS.” Low DAS was determined by starting with a cut-off of 100, based on the recommended score for satisfied versus unsatisfied couples (Eddy, Heyman, & Weiss, 1991). However, this only yielded 4 participants. In order to obtain a large enough sample in the Low DAS group, the team selected the cut-off for low DAS at less than 110. The cut-off for high DAS was 126, again, in order to obtain a large enough group size for the High DAS group.

The participants were categorized for each group by identifying their scores on a continuum within these variables (i.e., participants who reported both High PPTSD-R scores and Low DAS scores). Those in the High PTSD/Low DAS group showed high levels of PTSD symptoms and low relationship adjustment, conversely those in the Low PTSD/High DAS group showed low levels of PTSD symptoms and high levels of relationship adjustment. Any participants who did not fit these criteria (e.g., they reported both Low DAS and Low PPTSD-R scores) were omitted. In the final sample used for the current qualitative analysis, the High PTSD/Low DAS group included 5 male soldiers and 7 female partners in the study (n = 12). The Low PTSD/High DAS group included 6 soldiers and 7 female partners (n = 13).

Qualitative Results

Results of the research were placed into primary themes or categories, based on team consensus coding. These categories included: Posttraumatic Stress, Positive Relationship Adjustment, Implicit Relationship Adjustment, Negative Impact on the Relationship, Omission of Information, Trauma Recognition in Self, and Trauma Recognition in the Other Partner. Each couple was placed in one of two groups, High PTSD/Low DAS or Low PTSD/High DAS. The primary themes will be described below, including the total number and gender of the participants for each theme, supporting quotes, and participant code numbers for each quote (e.g., 1M = Couple #1, male partner; 4F = Couple #4, female partner). Table 1 provides a summary of the number of participants in each theme.

Table 1

Summary of Themes and Participants

Number of Participants in Each Research Category

Participant Group

High PTSD/

Low DAS

Low PTSD/

High DAS

Gender

Males

Females

Males

Females

Posttraumatic Stress

5

3

2

4

Positive Relationship Adjustment

3

3

5

4

Implicit Relationship Adjustment

3

7

3

6

Negative Relationship Adjustment

2

6

5

3

Omission of Information

2

3

0

4

Trauma Recognition in Self

1

3

3

1

Trauma Recognition in the Other Partner

0

6

0

3

Posttraumatic Stress

Posttraumatic stress symptoms were reported by many of the research participants, including 5 soldiers and 3 spouses in the High PTSD/Low DAS group, and 2 soldiers and 4 spouses in the Low PTSD/High DAS group. It should be noted that the posttraumatic stress theme included reports of symptoms in the soldiers from the qualitative interviews, not a diagnosis of PTSD. Examples of some of the reactions and symptoms reported by the participants are provided in this section. Nighttime disturbances were common to several of the soldiers in this study. Participant 10F recounted her husband’s experience with posttraumatic stress symptoms related to her husband’s dreams:

…when he first got back, he… had… a lot of dreams, and… um… (3 secs) sometimes he wouldn’t remember them… and sometimes… he… I think he just didn’t want… to talk about them… Um… (3 secs) but that was pretty significant right after he got back…Um… it was kind of strange, and, like, one time, he actually grabbed me, um… and… he had no idea that he was just asleep. Um… so yeah that was kind of weird. And there were times that he would just sit up in bed, and just be sitting there and I’d have to tell him to lay back down.

Participant 10F described what it is like to be there while her husband is experiencing these dreams. Even though the soldier was experiencing the symptoms, the spouse was affected as well by his sleep disturbances.

Participant 6M also reported sleep disturbances and waking nightmares. He described his experiences upon returning from deployment:

Hmm… you mean like the waking nightmares? I’ve had a few of those. I’ve watched a lot of people get hmm toasted over there. And they’d sometimes pull me out of sleep. Sometimes I don’t know where I’m at when it happens… There are quite a few of us guys. We’ve kind of started a group since we got back… Gosh, uh, the one’s that are having dreams, the waking nightmares are starting to talk to each other about it, we’re starting to break off from the ones that are just fine.

Some soldiers reported being greatly affected by the deployment. His mention of the group of soldiers who are all suffering from nightmares shows how forming a support system is important for those soldiers who are experiencing similar effects of deployment. He reported breaking off from the soldiers who are “just fine.” This implies that some soldiers came back without experiencing sleep disturbances or at least, for this soldier, he perceives some soldiers as experiencing no problems after their deployment.

Participant 44M reported sleeping problems, anxiety, and depression. The event responsible for his nighttime disturbances plagued him for months after his return from deployment.

So I jumped on the back of the truck, they unzip the bag and the first thing I saw was a decapitated body. And then I went from head to toe and I looked at all his injuries and to this day I can name every single one of ‘em. Every night when I go to bed, I see that, I see him everyday because that day 12 hours before he died, I was talking to him. I was talking to the kid that broke both of his legs and split his wig cause I was making fun of him about needing a hair cut… and… that’s why I see the shrink is because every night I have I can’t sleep, I’m on [specific medicine] from sleep and anxiety, I’m on [specific medicine] for depression cause every time I go to sleep I see his face unless I’m having a really good day which is rare since we’re getting ready for another deployment is the only time that I don’t have nightmares

This soldier clearly described how his deployment directly affected him. The recurring flashback and subsequent sleep problems are symptoms of PTSD. PTSD symptoms were reported by both soldiers and female partners in both groups. These examples show ways that PTSD has affected the lives of some of the soldiers and their spouses.

Positive Relationship Adjustment

Some c ouples reported “Positive Relationship Adjustment” in their interviews. In other words, the deployment did not seem to have adverse effects on their relationship satisfaction. Of the 7 females who reported positive relationship adjustment, 4 were in the Low PTSD/High DAS group. Of the 8 soldiers who reported positive relationship adjustment, 5 were in the Low PTSD/High DAS group. The following examples of the positive aspects of relationships through deployment show that the effects of deployments are not all negative for the people involved. Communication is shown as one important aspect of maintaining a positive couple relationship throughout the deployment. One male soldier replied to the question; “How is your relationship most affected by your deployment?”

You know, cherish every moment and talk a lot more. I never used to be one that could talk on the phone… kinda broke that habit, kinda broke that habit quick so… in that aspect communication uh has definitely improved. Uh, as well as maybe on my part showing emotion to her has definitely improved quite a bit so… I guess yeah can’t really share stuff with your buddies while you’re out there. I mean you can, but it’s not the same… you only get so much time on the phone so you call people and that one person you develop very strong… yeah relationship with. (13M)

Several soldiers discussed the importance of just hearing their loved one’s voice, and the energy they received from their spouse back home.

Another aspect in several interviews was the appreciation the individuals have for each other in these relationships. The time spent apart due to deployment does not necessarily affect couples negatively; there also were positive effects. Many couples reported an increase in appreciation for what the other does, for both the spouse on deployment and the one at home. Several couples mentioned the importance of spending time together and truly cherishing the other person. Participant 23M talked about having “we time” with his wife when asked about any positive outcomes as a result of the deployment:

My perspective on life… Uh, vowing to one of the things me and [Spouse’s Name] do now at least, you know I’d say a minimum of twice a week or maybe three times a week is we call it “we time.” It might, you know we will meet at [Restaurant Name] have a beer and some hors d’oeuvres and we’ll only be there an hour, but it’s just her and me. And uh we do a lot of that now and the kids almost joke about it. That it’s like, where are mom and dad? Oh, you know, they’re having “we time”, or “we maintenance.” So, we resolved to strengthen our, I knew our relationship was strong but you know I, this just made it even stronger.

Good communication and appreciation of the spouse were shown as important aspects for those couples that kept their relationship positive throughout and after the deployment.

Implicit Relationship Adjustment

Several participants made statements that were not explicitly examples of dyadic adjustment; however, they implied certain aspects of dyadic adjustment or ways their relationship had changed during or because of the deployment. These statements were placed into the category of “Implicit Dyadic Adjustment.” Some of these comments were not explicitly positive or negative, but were indications of change in their relationship. Of the 6 soldiers who reported implicit relationship adjustment, 3 were in the High PTSD/Low DAS group and of the 13 female spouses who reported implicit relationship adjustment, 7 were in the High PTSD/Low DAS group. One soldier discussed the changing roles he and his wife took on as a result of the deployment.

…our relationship is so dynamic, that, things are constantly in flux and with this deployment all the different roles she took on that I used to do and the different roles that the kids took on that maybe were formerly my wife’s role. You know it’s, you can’t, it’s harder to define roles now… it’s kinda like you know women do the dishes well,
whoever can get to ‘em at that time and has the time does the dishes whether it’s mom, dad, brother or sister. So, …(3 secs). I think you know we just we sense when one of us wants to either step back or step up and then it’s like, alright, fine.
(23M)

Although communication is an important positive aspect to couple relationships,
especially during deployments, it can also have negative aspects. One wife talked of the pressure she felt during the phone conversations she had with her husband during his deployment. Participant 31F responds to the question about whether she feels like an insider or outsider to what her spouse experienced:

Both I think, because obviously my reactions to him during our ten minute conversation impacts him. You know, when we’re talking on the phone for ten minutes a week, what I say, he’s gonna get off of the phone and think about that because that’s all he has to think about. You know, he is relying on me. I didn’t like that, he was using only me as a coping mechanism to get him through what he was going through. Well, that worked for him, um I didn’t like it because it was so much pressure, to say the right things or to not upset him or um, sometimes I didn’t know what he needed at that time. Did he need somebody to be light hearted and funny or did he need um me to tell him how crappy he has it? What does he need? You know he couldn’t tell me, because the phone lines were monitored and he can’t tell me what you just saw, you know. And so I might, and then at the same time I need sometimes to talk seriously, or I need a light hearted conversation and well, that would be off balance sometimes.

This female participant shared about what it was like being that one contact person the soldier gets to have once a week.

Another aspect of implicit dyadic adjustment is how the spouse at home feels about the deployment experience, both before the soldier leaves and after the soldier returns.

I get very frustrated with him before he goes because he will wait, he will work, work and work and work and work and work up until the night before he has to leave. And he says, he’ll tell me every time, 10 deployments and every time, “ I am going to save the last night just to spend with you.” He leaves and we didn’t spend any quality time together…that’s for when he leaves, but when he comes home it’s hard not to get jealous, because you get the hug then you get pushed aside and it’s” daddy, daddy, daddy, daddy,” and you got to wait until it’s bed time to get your husband. (39F)

This is just one example that shows how the spouse at home may feel about the deployment experience of the soldier. In addition to changes in their relationship, some participants described a negative impact on their relationship due to the deployment.

Negative Relationship Adjustment

“Negative Relationship Adjustment” included conflicts in the relationship arising from the deployment, which were manifested or observed during and after the soldier’s return, usually in the form of conflict in the relationship. Both soldiers and their partners reported this theme. Of the 7 soldiers who reported negative relationship adjustment, 5 were in the Low PTSD/High DAS groups; of the 9 female partners who reported negative impact on the relationship, 6 were in the High PTSD/Low DAS group. Most participants attributed the negative relationship adjustment to the lack of the soldier’s presence upon returning from deployment. Participant 31F stated:

As far as our relationship, um, it was not a good; it was a detriment totally to our relationship and a set back. And in fact when we moved, we were telling each other before um, we feel like we’re just now starting our marriage.

For other participants, the conflict in the relationship arose from their conscious or unconscious blaming of the soldier for the deployment. Spouses reported feeling abandoned and unaided in a time of personal crisis. When asked how her partner supported her during the deployment, Participant 39F stated, “He really didn’t, I mean, maybe he did for certain things but when it really counted, when I really needed him the most, he wasn’t there.”

Relationship adjustment may also be negatively affected by a partner’s apparent lack of support for their spouse. A soldier being deployed and not being physically with his family may be seen as a lack of support. The absence is understood and accepted, but the feelings of betrayal caused by the soldier’s absence may still be present.

Omission of Information

Communication is an important part of any relationship. If a partner is not present, there can be little or no communication, negatively affecting the relationship. At times, one person in the couple may edit what they say to the other, especially the soldier, while he is deployed, which may result in an “omission of information” between partners. The two soldiers who reported omission of information were in the High PTSD/Low DAS groups. Of the 7 female partners who reported this theme, 3 were in the High PTSD/Low DAS group. Participant 4M stated, “I really didn’t tell her while I was over there if I was in any type of danger or not. Just for her mental stability.” In some situations, both partners may justify the omission of information. Participant 4M justified not telling his partner about aspects of the deployment, “Just for her mental stability… not saying that she’s not capable but just for she has enough stress over here… you know I don’t want to give her extra stress.” The partner’s response to not being told information seems to usually be relief and/or gratitude; they understand the omission of information. When asked if her partner sees her as an insider or outsider to his deployment experiences, Participant 21F said:

He knows that I am not. I would ask him and he would say I wasn‘t going to tell you about that patrol because he didn’t want me to worry. I know that he didn’t tell me nearly what he was doing. He was sheltering me, which I appreciate.

Likewise, Participant 23F stated, “I was kinda surprised that he wouldn’t tell me… but then it made sense to me when he didn’t because I would have worried.”

In addition, when the deployed soldier returns, the spouse at home learns much more about what the soldier went through. Some soldiers withheld information from their spouses, believing that it was best for their spouse not to know about certain aspects of the deployment. They did not want to place more stress on their spouse. One female participant answered the question, “Do you consider your experience of dealing with him being deployed traumatic to you?”

While he was gone it didn’t feel like it. But when, when they come back, they are, they can tell you things that you didn’t know before. Then you hear these things of, “Yeah I went on a bunch of convoys and there were mortars blowing up and oh yeah my team leader got hit.” …it’s kind of better to not know while they are over there but then when they come back it’s like it all hits you at once. So it makes me more nervous for the next time. It’s just… in the long run, well yeah because not so much while he’s there because I dealt with my own things… and then when he comes back and it bombards you. And then for the rest of your life, it’s in the back of your head that, well, last time he did this and this and this and this. It’s always going to be there. You’re always going to be a little more nervous about it. (42F)

Spouses usually understand the omission of information regarding the deployment. Both soldiers and spouses are conscious of the stresses the soldiers experienced and this lack of information from the soldier is understood and sometimes even appreciated. Other spouses mentioned being told about the dangers the soldiers encountered during deployment once the soldier returned. This often makes future deployments harder, because they know what their soldier might go through.

Trauma Recognition in Self

The theme “Trauma Recognition in Self” refers to the soldier or the partner recognizing or identifying an experience they had as being traumatic. Interestingly, only 1 soldier in the High PTSD/Low DAS group identified personal experiences as potentially traumatic, while 3 soldiers in the Low PTSD/High DAS group were able to identify potentially traumatic reactions or events. Conversely, it was the females in the High PTSD/Low DAS group (n = 3) who reported more potentially traumatic experiences or reactions than the female partners in the other group (n = 1). The traumatic event soldiers recognized most often had to do with being on the frontlines and directly seeing their comrades injured or killed, as well as dealing with enemy action. The female participants also described deployment-related experiences that they viewed to be most traumatic for them. Participant 19M stated:

…you know we went and saved the other squad of Marines and that was the most traumatic, just seeing fellow American soldiers, just cause that was the first time that I had seen an American soldier be killed like that cause it was up close point blank. One of the most traumatic experiences was seeing that and then having uh my life flash before my eyes when I got hit with an RPG in my trap, in my vehicle.

Participant 2M recognized his deployment experiences as traumatic, but he reported no long-term effects from the event once he returned from the deployment:

There were traumatic, there were traumatic events, but it was nothing that I dwell on constantly or think, “Oh my God, I can’t believe that happened.” It just kind of like, “Wow, that’s really sad that that happened,” and it was traumatic at the time, but it, you know I dealt with it and went on. It wasn’t… it’s sad but it’s not, it doesn’t haunt me about it.

Conversely Participant 44M recognized how the deployment seriously affected him both during and after the deployment:

I got so stressed out because of my financials and my injuries, me being unable to do my job because I couldn’t walk or lift anybody over my shoulder. I couldn’t take care of her ‘cause I was injured, I just got so stressed out that I was going to kill myself.

Some partners dealt with their own traumatic experiences and reactions related to the deployment. When asked what about the deployment was traumatic to her, Participant 23F said:

I was [watching] FOX news all the time. Um, the people being kidnapped and beheaded. That was very disturbing. Um, and there would be, there would be times of reports that come in about this is going on or this bomb is going off here, and then after that, no communication from him. And so there’s the dread of hearing the worst or finding out the worst…“I haven’t heard from him in two days what is” you know… “how can I find out what’s going on” and that was really hard.

When asked how the deployment affected her, Participant 41F stated:

It made me age. Um, I could physically see myself aging. I got my first gray hair while he was gone. And I could see wrinkles appearing and maybe just the age that it hit me at, but the stress of it was, I could see that a great deal. A lot of sleepless nights.

Although the trauma experienced by the soldier and partner were vastly different, they were nonetheless very real to each of them. They recognized symptoms and how they were being affected by their experiences with the deployment. Deployment affects both partners, creating stress for each individual and potential stress in their relationship.

Trauma Recognition in the Other Partner

“Trauma Recognition in the Other Partner” is a theme based on trauma experiences being recognized and identified in the other partner by a participant. Participants reported knowledge of what their spouse went through and how they believe the traumatic events might affect them. The previous themes focused on participants having self-awareness about their own experiences, while this theme emphasizes that participants are aware of their partner’s trauma experiences and how those experiences affect their partner. Of note is the gender difference between males and females reporting possible trauma reactions or experiences, with females reporting more recognition of trauma experiences in the soldiers, particularly in the High PTSD/Low DAS group. No statements by male soldiers were coded for this theme. Participant 31F exemplifies this theme:

He’s been deployed a lot. You pick a country in the world, he’s been there. You pick an injury, he’s seen it. He’s dealt with burn victims, you know kids stuck in a land mine. I mean he’s seen and done it all. People having to clean up bloody aircraft time and time again… yet he has this resiliency about him that I can’t even understand and this past time my worry was that he wouldn’t be resilient enough because people as resilient as you can be, can only take so much… so it’s just, I worry a lot about, um, I think he has been traumatized and doesn’t know it yet.

Participant 44F recognized trauma reactions in her partner, who reported sleep disturbances, anxiety and depression, and how the effects of the deployment affected his transition home:

He couldn’t sleep. Uh and when he did sleep, all I kept hearing in his voice was about [Person 2]. That was the guy who died… in the beginning it was about [Person 2] …his eating habits were weird. He didn’t want to go out… he was more into me. He was afraid that something bad was going to happen with me… and it was just that he was always afraid when he got back something bad was going to happen.

The participant may recognize the trauma experienced by the partner, even when the partner does not. Participant 5F reported:

He had seen someone who had been blown up and decapitated, um somebody who had become a friend of his in the war zone that had their whole back completely blowed off… and it didn’t seem to bother him. And I asked him where it is, out of sight out of mind or something, but, the video yesterday that they showed them in this class, made him sick to his stomach and then he had like nightmares and stuff about it… to me its very disturbing and upsetting and I don’t see nothing wrong with him thinking it’s disturbing and upsetting. But I don’t understand how he can see the things first hand and it not bother him and then watch it on video and it bothers him.

Others recognized the trauma in the soldiers and used this knowledge to help them be conscious of the effects the trauma has had on them. Participant 42F explained this when asked what she had done to help her partner recover from the effects of the deployment:

…I try to warn him when he’s doing, when he’s having those, those ticks. If he’s being paranoid, I’m like, “It’s, it’s okay you’re in the [Place 6] we don’t have mortars here.” There’s cops and gate guards and all sorts of stuff for that and I let him know so he can be aware of it and can control it but other than that there’s not a whole lot I can do.

By calling attention to the soldier’s altered behavior, resulting from being deployed, the spouse is attempting to assist in the soldier’s adjustment to life post-deployment.

Discussion

The current study consisted of a qualitative analysis of 25 participants, including soldiers deployed to Iraq and Afghanistan and spouses/partners of deployed soldiers. The results of this study indicated several themes, including: Posttraumatic Stress, Positive Relationship Adjustment, Implicit Relationship Adjustment, Negative Impact on the Relationship, Omission of Information, Trauma Recognition in Self, and Trauma Recognition in the Other Partner.

Several themes should be noted, as they may provide insight into the experiences of these military couples. Omission of information was not seen as detrimental to overall relationship satisfaction but was appreciated in most cases. Soldiers reported they omitted information while they were deployed, but then shared information upon return. They indicated this was because they did not want their spouse to worry about them while they were deployed. Many spouses were surprised to hear what actually occurred during their spouse’s deployment; however, they were glad they did not know that information during the deployment. However, this caused fear in the spouse of future deployments due to the knowledge of deployment activity the spouse learned upon the return of the soldier.

Another interesting finding was the high number of participants who reported relationship satisfaction. This may be simply an artifact of the current study sample and should not be generalized to all deployed soldiers and their spouse/partner. Also, because this research was volunteer based, and not from a clinical sample, the nature of the participants may have tended to report higher relationship satisfaction.

Communication had the most effect on a couple’s relationship satisfaction. The more open and frequent the communication was, the less the couple’s relationship satisfaction seemed to be affected by trauma experienced. The less communication, the more negatively affected the
couple’s relationship satisfaction due to trauma experiences. It was also observed that couples who had stronger communication skills before the deployment continued that throughout the deployment and upon return. In couples that did not have strong communication skills before the deployment, their relationship suffered as a result. Many couples learned how to cope through phone calls and e-mails. Several of the participants reported their communication at home with their spouse improved as a result of the deployment, because that was all they had during their time apart.

One interesting observation is that all themes were reported by both groups. This means that it was not just the low DAS group who reported negative relationship adjustment or the high DAS group who reported positive relationship adjustment. The relatively equal numbers between the two groups in several themes (posttraumatic stress, negative relationship adjustment, trauma recognition in self, and omission of information) suggest that these groups may be more alike in their experiences of deployments. However, the two areas that did show a difference between groups (positive relationship adjustment and trauma recognition in the other partner) suggest that those with higher DAS and lower PTSD scores may have fared better in terms of their relationship than those in the other group in these two areas. Because of the limitations in the sample, these conclusions should be interpreted with caution, but are important to note and pursue in further research.

In addition, gender differences were found in some themes and are also important results of the current research. Specifically, implicit relationship adjustment, omission of information, and trauma recognition in the other partner were reported by more female partners than by male soldiers. Again, these themes are important to note but require additional research to understand whether these are key differences between soldiers and their female partners, or simply an artifact of the current sample.

Limitations

Limitations of the current research include the lack of participants falling into the clinical range of relationship satisfaction on the Dyadic Adjustment Scale (DAS), the lack of female soldiers, and the level of PTSD for the participants. The average DAS score for the sample was high (119), which is above the cut-off score of 100 suggested in the literature (Eddy et al., 1991). Within this study, 109 and below was used as the cut-off for low relationship satisfaction. This study did not have enough participants falling below 100 who also had high PPTSD-R scores, so many of the participants identified in the low DAS group actually fell in the satisfied range.

Another limitation was the level of PTSD in the participants included in the high PTSD group. Clinically, there is not a cutoff score to determine high PTSD symptoms based on the PPTSD-R. The two groups were identified based on where the participants’ scores fell on the continuum of their PPTSD-R and DAS scores. Therefore, scores equal to or over 33 were identified as high PTSD. There are limitations with our results, because there is not a clinical cutoff for levels of PTSD symptoms.

Some final limitations would be the lack of female soldiers in the study, as well as the small number of National Guard and Reserve unit participants. Because all the couples interviewed consisted of a male soldier who was deployed, the findings can only apply to this type of couple. The lack of female soldiers and National Guard and Reserve participants was not intentional on the researchers’ part; it was simply a matter of who volunteered. The relationship satisfaction of couples with the female deployed, or with National Guard and Reserve soldiers, may have very different results.

Further Research/Implications

Throughout this research, the team noticed several areas that should be further researched. Several participants mentioned expectations as far as the deployment and returning home of the soldier, as well as adjustment back to civilian life. These two areas should be studied further to determine if soldier or spouse expectations affect the relationship adjustment throughout the deployment. Also, any previous military experiences of nondeployed spouses could play a role in their expectations, as well as the dyadic adjustment throughout the deployment process. Spouses who grew up in military families, or were in the military themselves, may have entirely different expectations than those who have no prior military experience.

Within this study, all soldiers were active duty military. It would be interesting to compare the effects of deployment on National Guard and Reserve soldiers with active duty soldiers. Also, as mentioned in the limitations, there were no female soldiers in this study. Research is needed to see how the deployment of female soldiers affects their relationship.

In summary, we can no longer consider war trauma to be strictly an individual experience. The systemic repercussions of these events on partners and on the soldiers' home life require attention. As Figley (2005) stated, “The secondary effects of war on the family are widely acknowledge but rarely studied” (p. 227). The stress of war deployment impacts both the soldiers serving their country and their spouses/partners, who, in reality, also are serving the nation by maintaining their lives here, while they wait and hope for the safe return of their soldiers.

* Faculty member

**Graduate student

Note: Support for this research was provided by funding from a Kansas State University Small Research Grant and the Kansas State University College of Human Ecology SRO grant.

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