Family members hang in delicate balance, connected at the center like a wind chime. If something--good or bad--tugs at one member, then the others may lose their equilibrium and come clanging together noisily. This reaction is especially true for families who have loved ones going to or returning from war zones such as Iraq and Afghanistan.

The unknowns of war can be formidable for those who experience combat, particularly for National Guard and Reserve troops who seem to go from civilian to warrior status overnight, leaving families, jobs, mortgages and other responsibilities when they are deployed. It is also a frightening and uncertain prospect for loved ones who struggle to keep things running smoothly at home until their soldier returns.

As circumstances continue to change, the people involved in the situations also change. Things get even more complicated when a soldier returns with indications of post-traumatic stress disorder (PTSD). Some come home emotionally numbed by what they've experienced. Others may try to recapture the adrenaline rush of combat with risky behavior. Many cannot sleep, and when they do, their sleep is invaded by nightmares. In a misguided effort to relax, forget, or be more social, they too often attempt to self-medicate with alcohol or other drugs.

Luckily, the difficult transition from combat to community is a bit easier because of what we've learned since the Vietnam War. For instance, stress control teams comprised of professionals in fields such as medicine, psychology, sociology and religion attempt to prevent or reduce emotional trauma. An increasing number of military units have established family readiness groups to educate and support our troops and their families.

"We don't want to wait until crisis hits," said Lieutenant Colonel Mary Erickson, an officer in an Operational Stress Control program that oversees Army personnel in a six-state region in the Midwest. "We meet with soldiers and families before they mobilize and talk about the entire cycle of deployment, including the homecoming. We give them tools to build resiliency and provide extensive information and resources."

According to Erickson, family readiness groups provide a valuable network and support system for families. "If you are alone, you might feel you are the only one with those feelings. You will still have fears, but there might be less dread if you connect with others who are going through the same thing. And it is extremely important for the soldiers to know there will be a support system in place for their loved ones when they leave."

Erickson said that stress teams work with the family readiness groups throughout the unit's deployment. Some units come home from Iraq for two weeks and have to return again, which is terribly hard on families.

"We might suggest meeting at a neutral location instead of having the soldier come home," she said. "We encourage them to take the time to just be together instead of doing a lot of things." Some family readiness groups work with school personnel, employers and others to figure out ways the wider community can better support its soldiers and their families.

Education, support and early intervention are critical precautions, yet even with innovative programs an estimated 17 percent of soldiers return from Iraq with PTSD--a psychiatric disorder that can affect the whole family in much the same way alcoholism does. Without appropriate intervention and treatment, the family system becomes focused around the soldier's problems. Without help, spouses and children can fall into the same "don't talk, don't trust, don't think, don't feel" patterns that grip families of alcoholics.

It is important for PTSD families to accept that they cannot "fix" their soldier and that they need their own independent support system. Twelve Step groups such as Al-Anon can provide invaluable tools to help families establish healthy boundaries so they can truly "support the troops."

Erickson advises that families go slowly and don't force things with their soldiers. "Don't demand that they talk to you, and don't be hurt if they find it easier or more comfortable to turn to other soldiers for support. Try to remember that this isn't about you."

Erickson suggests Military OneSource (http://www.militaryonesource.com/; 800-342-9647) as a comprehensive place to start for those who want more information about programs and services for troops and families. In addition, Al-Anon meetings are held in 115 countries, and there are over 24,000 Al-Anon groups worldwide. For more information, call 888-4AL-ANON or visit http://www.al-anon.alateen.org/.

--Published June 27, 2005