The shocking massacre at Fort Hood has been discussed from many angles, and the questions it raises will hopefully guide us for the future.

Among the questions raised that were closest to me were about the significance of women in the military and about the special stressors on caregivers. Because I think that both are underserved populations where we don’t have adequate facilities in place to deal with the growing need, it is important to see what lessons could be learned from Ft. Hood. Because in Israel I also had the opportunity to work with women in the military who were also caregivers, I could see the immediate benefit of services.

The role of women in the military has changed dramatically since 2001. They now make up 11% of the armed forces and found ways to serve in ground combat. They had to adapt to unfamiliar challenges in military culture such as lack of privacy, and also faced misunderstanding, disrespect, sexual harassment and rape. Yet they fought for the opportunity to serve their country on an equal footing with the men, and worked very hard to earn respect. They so distinguished themselves that they were called “lionesses.” 

Although their rate of PTSD is approximately the same as the men, they still face particular challenges upon their transitions back to civilian life. This transition period is tremendously tricky, and a place where many combat vets cannot adapt. It is often the qualities that serve during combat that become dysfunctional at home. For example, aggression and hypervigilence are valuable during combat, but can cause great interpersonal disruption and alienation in civilian life. At a retreat for returning combat vets recently, I heard women say that they were hurt from close family members and friends who called them “bitch,” “baby killers” or “psycho.”

Being a woman warrior has nobility, and many of the women I met impressed me with their intensity and commitment to serve. The first to first to fire at Major Hasan was a woman who faced him directly. She was called a “hero” and applauded for her courage. She was wounded in each thigh and the wrist, somewhat like Christ.

How to be a warrior back at home? These women must have services when they get home. Besides help with their physical wounds, they need help healing psychological wounds. They may have experienced rape, shame, and discrimination. War has changed them; they cannot go back to being the same person, wife or mother as before. How can they reconcile the archetypes of warriors and woman?

Women in the military have already demonstrated great bravery and value. They have just begun to need services, and it would be wise to be prepared.

Caregivers Support

The other extremely compelling part of the story had to do with the fact that Major Hasan  was a caregiver, a psychiatrist.  The issue of “Compassion Fatigue” has only recently attracted attention and understanding. The multiple stressors faced by caregivers include not only broken bodies and broken souls, but their own safety. Caregivers can absorb trauma of others, and develop a secondary traumatization. This year there were apparently 117 suicides and only 408 psychiatrists to cover. Programs need to be in place to help the helpers. Dr. Moore, quoted in The New York Times, on November 8, said that “mental health evaluations of therapists themselves were virtually nonexistent.”

Sometimes these categories overlap; for example, many of the women combat vets I met worked in hospital settings or with people. Some had nightmares about body parts and burned corpses that didn’t look human.

I worked with programs in Israel that helped the caregivers. Called the “Casualty Division” of the “Israeli Defense Forces”, it visits families of soldiers and wounded soldiers in hospitals. It is supervised, however, by a family therapist who mothers the young women officers and gives them training workshops and individual attention. The human connection is the best buffer against stress.

Blessings: This apparently random act of violence can lead to improved services for women and caregivers in the armed services, and help them transition back to civilian life with dignity.

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