Tech Helps Soldiers Cope With Invisible Wounds of War

Some war injuries are obvious at first glance, like missing limbs or facial burn scars. Others remain invisible to the casual eye — post-traumatic stress disorder, brain injuries, broken hearts.

Yes, broken hearts.

"These young men and women have formed their identities around being brave, strong, courageous, hard-bodied, brilliant," Romberg says. "Then, if they receive an injury or a brain injury or PTSD, how do you help them cope with this loss of identity? It’s added on top of the normal discomfort of dating, of asking, ‘Do you like me? Do I have something of value to offer? Am I attractive enough?’ and wondering whether someone will love them."

The military does not have a fabulous track record for making sex and relationships a priority, other than promoting heterosexual marriage and families as the foundation of stability and an ideal worth defending. Yet how can you simultaneously encourage marriage while ignoring the emotional toll of deployment and combat on a relationship?

But finally, even the military is beginning to acknowledge the importance of sexuality as a crucial component of overall health. And as mental health professionals and policymakers gathered in Washington, D.C., last month for the Wounded Troops and Partners: Supporting Intimate Relationships conference, it became clear that technology is the key.

"Technology is allowing us to provide more services and to make services available to more people," says psychologist Barbara V. Romberg, Ph.D., founder of Give an Hour, which matches soldiers and their partners with volunteer mental health professionals. "We can do so many wonderful things we couldn’t have done a decade ago. Think of the veterans who came back from Vietnam; they were isolated and alone. Maybe they were lucky to find someone who could help them, but it was so much harder."

One application in the works is eHART, an extensive online assessment tool developed by Sexual Health Network founder Dr. Mitchell Tepper and Chief Operations Officer Kelly J. Ace, Ph.D., J.D. The tool asks extensive and detailed questions about sexual functions, romantic relationships and general health history, then returns information tailored to you and a summary you can take to a health care provider — if you want. None of the information is shared with anyone else unless you want to share it.

"People are more comfortable revealing sensitive information about sexuality to a computer than to a person," Tepper says. Especially when military approaches to sexual health are often delivered by people without any training in addressing sexual issues.

Tepper cites an example of a servicewoman hospitalized with a spinal injury who had lost her interest in sex. She was asked as part of a routine screening after deployment whether she had experienced sexual trauma during her tour. She said no, even though she had been raped, because she was asked in an impersonal manner in front of other men and women who could overhear her answer. She also did not mention the rape to her doctor — nor did she receive any counseling or education about sex.

She eventually did tell a psychiatrist about the experience, who then helped her talk to her husband. But her reluctance to report the rape or to ask for sexual information after her injury is common.

Many service members worry that admitting to mental or sexual health issues will negatively affect their military careers. It’s especially difficult for young people to publicly address sex, as you don’t have a lot of practice in your early 20s talking about relationship and sexual issues with partners, much less with doctors.

Advances in prosthetics and other hardware (like Darpa’s mind-controlled robotic arm or the iBot wheelchair) can provide more mobility and independence for those who acquire a disability during their service (assuming the government will fund this level of care), but no matter how sophisticated the devices, they cannot address the psychological issues that accompany the permanent injuries.

"These young men and women have formed their identities around being brave, strong, courageous, hard-bodied, brilliant," Romberg says. "Then, if they receive an injury or a brain injury or PTSD, how do you help them cope with this loss of identity? It’s added on top of the normal discomfort of dating, of asking, ‘Do you like me? Do I have something of value to offer? Am I attractive enough?’ and wondering whether someone will love them."

Romberg sees a number of ways in which technology is helping troops and their partners cope as they return home. She is talking with one organization that might partner with Give an Hour to create online communities where people affected by the wars can share their experiences and ask questions of others who have gone through similar events.

She also sees great potential in virtual worlds, which are already being used to treat PTSD in veterans, not just of Iraq and Afghanistan, but of Vietnam as well.

The Army has begun offering telepsychiatry, which offers soldiers therapy over a private web videoconference. In addition to obvious privacy factors, it also enables them to receive therapy over long distances — even in the field.

"One thing we’re all calling for is more training up front, before deployment, to help people deal with this and build up emotional resilience," Tepper says. "I’d like to see sexual health services become more comprehensive, not just offered when someone has an STD or a pregnancy. It should include how people feel about themselves — the touchy-feely aspects. That’s quite important when people start thinking they’re no longer capable to be in their role as (partner)."

I’m living proof that virtual spaces can be highly effective in treating sexual trauma, as it was cybersex that healed me from the effects of sexual abuse. They’re also an excellent "practice ground" for transitioning back into life as a single civilian and for meeting potential partners who understand what you’ve gone through.

I asked Tepper whether soldiers were making the best use of technology to stay intimate while they are apart, and he laughed. "People do know they can use the internet to stay in touch, and I don’t think we need to teach them how to talk on the phone in a sexual way," he says. "Not that cybersex isn’t a good way to stay connected, but we want something beyond that."

See you in a fortnight,

Regina Lynn

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