In 1969, Mary Ann Meigs was a new bride whose husband Montgomery, an Army captain, had just been deployed to Vietnam. Soon after he left, she developed a bedtime routine to cope with her separation and anxiety.
"I would lie in bed and reassure myself that today there was no knock on the door," she recalls. "And that meant that he was one day closer to coming home."
During the Gulf War 22 years later, Meigs' 16-year-old son, Matthew, developed his own war-related reaction after Montgomery, now an Army Colonel, took him aside shortly before his deployment to Saudi Arabia. Meigs listed what he expected from his son if he did not return from the Persian Gulf.
Although Mary Ann noticed that her son slept a lot and spoke little of the deployment, she did not learn of the conversation for more than 10 years.
"I had no idea of the burden that he was carrying," she says.
Her family may have adjusted to the war's stressors better, she says, had therapy or family support groups been available.
That's why Mary Ann and Montgomery Meigs, who retired as a four-star general, were founding advisory board members for SOFAR (Strategic Outreach to Families of All Reservists), a group of more than 70 psychologist volunteers offering free individual or family therapy as well as support groups for families of Army Reserve and National Guard members who are stationed in or returning from Afghanistan, Iraq and Kuwait. The group's goal is to help them cope with the stresses of the war.
The Meigs' experiences as Army family members are not unique, says psychologist Kenneth Reich, EdD, co-founder of SOFAR and president of the Psychoanalytic Couple and Family Institute of New England, SOFAR's umbrella organization. Indeed, the "secondary trauma" associated with war is extremely far-reaching, Reich says. Separation and anxiety put stress on troops' marriages and relationships, and often make children resentful or wary of their deployed parents, he notes.
Add to that the experience of war itself: More than one in six soldiers in Iraq who experienced combat exhibited symptoms of major depression, serious anxiety or post-traumatic stress disorder, according to a July 2004 New England Journal of Medicine study (Vol. 351, No. 1, pages 13-22). When those statistics are combined with the difficulties that families of reservists and guardsmen have-few outlets or resources for support or care-their situation can be particularly trying and isolating, Reich says.
SOFAR aims to address those problems by providing a range of psychological services that cultivate the stability of troops' family networks, encourage families to develop contingency plans and help them effectively manage sensitive problems as they occur.
Between October 2001 and November 2005, nearly 1.19 million troops have deployed to Iraq and Afghanistan, according to Defense Department spokesman Maj. Todd Vician.
Assuming that each of those troops has seven immediate family members-such as parents, spouses, siblings and children-the wars have closely affected more than 8.3 million people, Reich says. Add in neighbors, friends and in-laws, and the two wars may have affected nearly 50 million Americans, he says.
"As people's loved ones go to war, everyone can figure out what the soldiers encounter in combat," he says. "[Though] the civilians that are left behind don't show scars, they suffer enormously."
To help mitigate some of that secondary trauma, Reich and SOFAR co-founder Jaine Darwin, PhD, a former Div. 39 (Psychoanalysis) president, pitched the SOFAR pilot program to the Army Reserves. After two years of negotiations with the military, the pilot launched last April. The psychologists are working with the Family Readiness Group of the Army Reserves' 883rd Medical Company, 220th Transportation Company and other units to help families throughout the troops' deployment alert, mobilization and reunion. SOFAR volunteers provide individual and family therapy and lead support groups on topics like stress management, anger management and general coping skills.
During the Family Readiness Group's monthly meetings, Darwin or other SOFAR volunteers lead a 20-minute discussion group focused on common emotional stresses and overview SOFAR's services. They then divide the participants into four breakout groups-parents, spouses, significant others and children-to focus on the specific needs of each group.
The impact of the breakout groups has been enormous, says Rick Croucher, civilian director of New England's 94th Regional Readiness Command.
"Everyone feels like they get the individual help that they need," he says. "And it's helping people direct their emotions in a positive way."
SOFAR has seen an upsurge in calls for services since the 883rd had its second deployment in October and the 220th had its second deployment in November. Many, Darwin says, are unsure how to cope.
For instance, one soldier's wife refused to bring their children along to say goodbye on the day he deployed. She said that she couldn't stand to see them say one more goodbye.
Building an effective model
One of the keys to SOFAR's success, says Croucher, is the lack of red tape needed to procure services. Since the services are free and do not require health-care coverage, SOFAR requires families to sign only one consent form before they perform services.
Since SOFAR began working within the family briefings last April, Croucher has seen a significant increase in the number of families attending.
"The families feel as though they are getting the personal services they need," he says.
Although Reich and Darwin say the work has been trying, they both consider SOFAR to be a success. That's why they aim to expand the program nationwide this year with the assistance of APA Div. 39, the American Psychoanalytic Association and national social work and psychiatry organizations.
"We have a terrific opportunity to intervene and make a difference," Reich says.