Uncovering The Wounds Within

By Mark I. Nickerson and Joshua S. Goldstein

America has its hand—if not its heart—in many wars: Afghanistan, Syria, Iraq, the Islamic State, and Yemen. Hundreds of thousands of returning veterans (and their families) struggle with post-traumatic stress disorder (PTSD), and the nation is poorly equipped to address their needs. A new book, The Wounds Within: A Veteran, a PTSD Therapist, and a Nation Unprepared, recounts the tragic story of Marine Lance Corporal Jeffrey Lucey, who deployed early in the Iraq War, battled PTSD after returning home, and set his family on a decade-long campaign to reform the Veterans Affairs system and end the stigma around military-related mental health issues, including suicide. The story is told from the point of view of Lucey’s psychotherapist, Mark Nickerson. Driven by the family narrative, and by later case histories of Nickerson’s veteran clients, the book explains PTSD and how it can be treated. With coauthor Joshua Goldstein, an award-winning writer, Nickerson grapples with big issues: America’s attempts to cope with the millions of returning veterans from Iraq and Afghanistan—from belated reforms to overwhelmed military families to uniformed and disengaged civilians who too easily wash their hands of responsibility by simply saying, “Thank you for your service.” The Wounds Within combines a moving and compelling human drama with national policy and a clinical explanation of how to heal veterans’ traumas. What follows is an excerpt from the book, published earlier this year by Skyhorse Publishing.

The Reunion

The scene was reminiscent of the old Civil War song “When Johnny Comes Marching Home Again,” written by conductor Patrick Gilmore for his sister Annie to comfort her while her fiancé was away with the Union Army. “The men will cheer and the boys will shout; the ladies they will all turn out.” It is a timeless scene, repeated after most of America’s wars. It has been repeated countless more times as two and a half million Americans have returned from Iraq and Afghanistan.

At these homecomings, a feeling of hopefulness and relief enlivens the air. The civilians desperately want to believe that all is well, that order is restored. They want to “fill with joy the warrior’s heart,” as the song says, and to put war firmly behind them. But often the warriors themselves harbor ambivalence about such celebrations. While away, they have craved this homecoming and imagined it a certain way, yet when it actually happens, it feels different. In war they have seen, and perhaps done, terrible things—things that the happy men and ladies of the iconic song might never understand and, worse, might not really want to know about. Yes, the vets are home, but likely as not they have changed. The faces of their parents, siblings, lovers, and friends are familiar, but will these people understand or connect with the veterans? On the outside, of course, the returning heroes are all strength and smiles.

It was a sunny day, July 14, 2003, when one particular family waited expectantly in New Haven, Connecticut, for their “Johnny.” Their guy was Lance Corporal Jeffrey Lucey. His parents, Joyce and Kevin, were there to greet him, along with his sisters Debbie and Kelly, his girlfriend Julie, and family friends.

Jeff ’s mother, Joyce, still recovering from a stroke she suffered while Jeff was away, was tired but eager. She had birthed this boy, raised him, seen him off to war, and couldn’t wait to get him back. As the arrival was delayed, the family paced around the parking lot, looking at the ocean and waiting.

Jeff’s father, Kevin, looked around and remembered how different the mood had felt the last time they were there. It had been a night of gloom and fear as Jeff’s unit had slipped into the darkness at 4 AM to an uncertain war in a distant land. On this summer day, however, the moment was festive and bright.

People laughed and chatted with glee, making instant friends with those around them. The suspense continued as the buses were late. Word came that they had missed the exit but had turned around and were on their way back. Amidst the excitement, Kevin peered over the ocean and thought, “My God, everything looks so wonderful, peaceful, and beautiful. The world is coming back to us again.”

Finally, there was a stirring in the crowd. The faint sound of sirens grew louder until everyone saw the police escort turn in with its lights flashing and sirens trumpeting. Then the first glimpse of the buses sparked a wave of excitement. The buses slowly pushed alongside the crowd, but the mob wouldn’t allow them to go any further, and the Marines hurriedly disembarked. The crowd surged forward, clapping, cheering, and yelling. Everyone was looking for their Marine, and the Luceys found theirs.

Jeff looked great—tan, slender, smiling. He seemed surprised that so many people had come. Jeff said later that none of the Marines had expected the welcome home and the greeting that they received. Jeff was dressed in Marine fatigue camos, mostly sand-colored, with swooshes of brown and green. Lucey was printed on his right pocket and US Marines on his left.

Jeff ’s girlfriend, Julie, carried an American flag and a bouquet of yellow and red flowers. They embraced, kissed, and then just gazed at each other, their noses touching, with the brim of Jeff’s hat resting on Julie’s head.

Kevin had been video recording the greetings. Now it was his turn, and he passed off the camera to his wife. Father and son embraced each other heartily. Jeff leaned his chin into his father’s shoulder, holding on with his right hand squarely on his father’s back. For several seconds, Kevin held his son firmly with both arms, his chin over Jeff ’s shoulder. Kevin was overwhelmed with joy and relief. He choked up as he whispered, “Welcome home, Jeff. Thank God, you are safe and sound.”

A Call for Help

Nine months later, I received a voicemail message at my psychotherapy practice, in the town of Amherst in western Massachusetts.

I had been providing individual and family therapy in the community for many years and had helped many people address a broad range of issues that cause people to seek therapy. It was on April 29, 2004, and the voicemail was from Joyce Lucey. “I think you probably remember my son, Jeffrey. You saw him when he was a teenager,” it began. “We’re wondering if you would be willing to see Jeffrey. He’s really not doing very well, and he won’t talk about it, but I think he’s willing to see you.” Jeff was living with his parents in the small town of Belchertown, Massachusetts, next to Amherst.

Joyce went on to explain that Jeff had served in Iraq, and on his return he seemed OK but had gotten “worse and worse” over the last few months. She and Kevin were “really worried about him.” But they couldn’t convince him to talk to anybody connected to the military. He was afraid it would only make his life worse if anyone in the military found out how much he was struggling.

Since I was a private therapist, our confidential sessions would not show up on his military service record. Joyce added, “He said he liked you when he saw you before and said he would see you again, but I’m not sure we can really get him to go.”

I remembered Jeff pretty well. I had seen him about a dozen times when he was 16 years old, eight years earlier. At that time, his grades had dropped, he was getting into mischief, and his parents had insisted he see a therapist. When we met for the first time, he agreed he wasn’t taking his life very seriously. He continued to come in voluntarily, and we met periodically for about a year. He stayed out of any serious trouble, improved his grades, and seemed to be moving in a better direction.

When Jeff Lucey walked into my office in 2004, the year after the invasion of Iraq, I was not yet prepared to deal with traumatized veterans returning from war, and neither was the rest of the country for that matter. Like most community-based therapists, I had never worked with a veteran who had just come back from a war zone, as the last such wave had ended in the 1970s after the Vietnam War.

The Department of Veterans Affairs (VA), as it has since proven, was similarly unprepared for the wave of need that was about to hit its system. In 2004, most Americans supported the “war on terror” and did not anticipate its many costs.

In 2004, neither the public nor our political leaders could imagine that a decade later some two and a half million Americans would have served in Iraq and Afghanistan and that hundreds of thousands of them would suffer from post-traumatic stress disorder (PTSD).

Yet here we are…as the last American combat troops (hopefully) trickle back from Iraq and Afghanistan. More than 6,000 U.S. personnel have been killed, and more than 50,000 wounded. Among the wounded are more than 1,500 amputees, nearly 7,000 veterans with the most severe forms of traumatic brain injury (TBI), more than 250,000 with mild concussions, and more than 300,000 with symptoms of PTSD.

The VA, which has been charged with caring for these returning vets, has a backlog of cases that have been at a standstill for four months or longer—sometimes much longer. That’s a long time for vets to wait to find whether they will get some kind of government assistance….

In 2014, a scandal revealed widespread falsification of wait-time data for vets using VA services. VA administrators collected bonuses for reporting falsely that wait times were decreasing. Vets were dying while they waited for appointments. Secretary of Veteran Affairs Eric Shinseki resigned, and government promised reform. The U.S. Congress, in a rare act of bipartisanship, authorized additional funding for the VA.

A decade ago, as Jeff Lucey fell apart after returning from Iraq, nobody could conceive of what would unfold in the years to come.

As it turned out, the Lucey family spent the next decade working to reform how America cares for its returning vets. I spent the same period advancing my skills with a powerful psychotherapy approach called Eye Movement Desensitization and Reprocessing (EMDR) and training other therapists to use it to treat vets with PTSD….

The most intense period for Jeff’s unit came early in the war as the Marines moving northward attacked the Iraqi town of Nasiriyah on the Euphrates River. It was March 2003. This was the biggest and deadliest battle for the Marines, with 18 of them being killed on March 23 alone. What part Jeff played during the battle is unclear…. He only partially referred to his activities in letters or later in person. So his story is incomplete, not unlike many accounts of war. “We know something happened to Jeff out there,” his father would later say. “Nobody will ever completely know. Things happened that changed him….” After returning home, Jeff referenced a significant incident during his time in Nasiriyah… .At some point during the complex and sometimes chaotic operations, Jeff reported he was driving with at least one other Marine, who was his superior, and they came upon two suspicious Iraqi men by the road in a remote area. Jeff’s superior apparently decided the men were dangerous and ordered Jeff to shoot them at close range.

As Jeff later confessed, he stood there facing the two men with his gun shaking.

They were about Jeff’s age, and he thought to himself that they could be someone’s son, brother, or perhaps father. A voice behind him said, “Pull the fuckin’ trigger, Lucey.” Jeff would later recall the closeness of the shooting, the loud sound, and the blood. Back home, Jeff would keep two dog tags on him constantly and said they were from the two men he killed.

Jeff wrote to his girlfriend Julie, “I would never want to fight in a war again. I’ve seen and done enough horrible things to last a lifetime.”

Mark I. Nickerson, LICSW, is a psychotherapist and internationally recognized expert on the treatment of post-traumatic stress disorder (PTSD). He teaches and consults widely on trauma, veterans, men’s issues, and other topics, and has practiced individual and family psychotherapy in Amherst, Massachusetts, for 30 years. He is a past president (2014) of the International Association for Eye Movement Desensitization and Reprocessing (EMDR), a leading PTSD treatment. www.markinickerson.com.

Joshua S. Goldstein is professor emeritus of international relations at American University, an award-winning author of many books and articles on war and society, and a frequent media commentator. See www.JoshuaGoldstein.com.