Getting out of the military is hard. By the time you've reached your end of active duty you'll have spent years around people who dress the same, went to the same basic training, worked the same or a similar job, and understood even the most obscure jokes you made about military life. It's a lasting change, and when you leave it behind it can be disconcerting to feel like the partner you've come home to is more of a stranger than Private Schmuckatelli who grew up 1,000 miles away. You feel like you've become a stranger in your own home.

 If you're a combat veteran, there can be an added complication to re-establishing intimacy, beyond that perceived disconnect. Now, you have to contend with the memories of rounds whistling by you, and the nervous anxiety of patrolling a street wondering if every piece of litter hides an IED. It all adds up, and for a combat veteran, intimacy can seem too much like letting your guard down. After all, it requires you to be vulnerable, and when you're coming from a situation where letting your guard down call kill you and your friends, it's hard to let go of that survival mindset.

And when you've been wounded in combat, vulnerability can be even harder to embrace. Added to all the above interference, you now may have a different physical appearance or ability that factors into the equation, with all its attendant psychological baggage. You may not recognize the person in the mirror as you, and how can you be intimate when you're no longer you? No one would ever want to be with the stranger you see in the mirror, you think. Or if your body doesn't work the same as it used to, how can sex or intimacy ever be the same? However, there are steps you can take to accept and embrace your situation, to thrive in this 'new normal'. There are ways to reconnect with your partner (and yourself), accept intimacy, and come to see the veteran in the mirror is you - a person deserving this love and affection.

The Psychology of Combat Veteran Intimacy Issues

Post Traumatic Stress Disorder (PTSD) is in the news nightly. There are countless studies on the subject, and there are even studies on how PTSD affects intimacy among veterans. With all this talk about veterans - psychology, and all the effort being put into treating vets, it's surprising how intimacy issues can still go unrecognized, and how long they can go untreated. What is often missed is context, and how things look from the veteran's perspective.

• The Disconnect Between Reality and Memory. Service members leave home for months or years at a time. While they're gone they do nothing but look forward to returning home to the everyday life that most Americans take for granted. But the reality rarely matches what they've imagined. They return to find their children don't recognize them, or may be frightened or resentful of the 'new' person in their life. Their spouses have grown used to life without them, and may be more independent than they were when the veteran left. All of this can make the veteran feel like an unwanted presence - and that includes how they feel in the bedroom.
• The Military Mindset. The above disconnect is compounded by the military mindset. In the military you don't discuss why you need something: you demand it. If you need it urgently you demand it loudly, and as abrasively as possible. At home this creates a feedback loop where the veteran needs their needs addressed, the spouse hears meanness or cruelty where none is meant, and reacts negatively. This cycle of negative feedback deepens the division, and can create barriers to intimacy between partners. 
• The Road to Anxiety and Depression. Add into this already loaded situation the suspicion and paranoia that kept the veteran alive in a combat zone, and you have a recipe for anxiety, despair, and self-loathing. This can create a lack of desire for the veteran, and an inability to perform in bed. It's all the worse because it's coming at a time when they most desperately need love and affection to return to society.

Eventually, this can lead the veteran to wonder if their own family is better off without them. Veterans of any stripe may even find themselves driving their loved ones away. Out of a misplaced sense of self-sacrifice they may even think driving them away is an act of love. Nothing could be further from the truth. The very root of the problem is a failure to communicate, and with something as simple as telling your partner how the world looks through your eyes, you can begin to escape the trap, and get the intimacy and closeness you need to feel at home again.

Communication is Always the First Step

The first step to restoring intimacy is to communicate the need to be needed. Communication is the only first step - there is no other way to resolve the misunderstandings that have arisen, or to keep them from happening in the first place. But putting away stubborn pride and admitting you want to know that you're still wanted isn't going to be easy.

Communication is only one step, though, and the only way you'll get to a solution is to admit there is a problem. Colloquialisms aside, love isn't a battlefield, and when you think you're sucking it up, all you're doing is hurting the people that love you. Unfortunately, wounded veterans face all the same psychological challenges as other veterans, and may have a physical impediment that makes intimacy a mechanical as well as emotional challenge. In male veterans with psychological issues that are causing them erectile dysfunction, this is especially difficult, as they're not going to want to admit that they have a problem.

So what do you do? You need to find, or make, the time to talk to your partner about intimacy. You can start by setting aside a little time for just the two of you. I would suggest a movie night in to try and talk it over in private. If you can't bring yourself to do this, then it might be time to consult a professional. Combat and wounded veterans are both eligible for free family counseling through the VA, and a professional can help you find the words to explain how you feel when you're struggling to. Once you get started communicating, you may be surprised how easy the rest can be.

Wounded Veteran Intimacy Is a Physical and Psychological Problem

Service members are generally in pretty good shape, and generally take a certain amount of pride in it (and rightly so!). An injury can change that. It can change how you live (and love) your body, your life, and your whole sense of who you are. This can make performing sexually a challenge physically, but also mentally.

The three most common combat injuries can all bring their own challenges to the bedroom.

• Traumatic Brain Injuries (TBIs) are highly variable injuries, with each being entirely different. They can affect mood, personality, and veterans - physical abilities - any of which can interfere with sexual performance, but also sexual desire.
• Spinal Injuries affect the path through which all signals from the brain travel, so this can seriously affect a wounded veteran's ability to perform sexually. The symptoms can be anything from paralysis to chronic back pain, which will require some changes in the veteran's sex routine.
• Amputation creates a serious alteration to everyday life, and not surprisingly, can create one in bed, too. The loss of a limb can remove some of the physical support needed to engage in sex, take some positions off the table, and change a vet's perception of their physical self.

The physical hurdles of both the day-to-day and the bedroom can be overcome with the help of your occupational therapist and various aids (sex aids to be discussed below). The psychological hurdles, however, are the ones that might take a bit more work. If you need your partner's caregiving help with basic tasks, this shift in roles might leave you feeling worthless and undeserving of intimacy - keeping you from trying to rebuild an intimate relationship. A partner who has taken on a caregiving role can end up feeling unappreciated, and like their partner isn't attracted to them (when in fact the wounded partner just feels unworthy). Communication is key to making this known, and sex is a vital part of knowing for sure that these feeling are false.

Sex is a vital part of life. A veteran has already sacrificed years of their life for others, and wounded veterans have sacrificed a part of themselves, too. In either case, there is no need to sacrifice any more. Any injury sustained, whether physical or psychological (or both), is a challenge to overcome - not the end of life, or of your sex life. Counseling and communication help with the psychology of sex and intimacy, and devices can help with the mechanics of doing the deed.

How Veterans Can Take Back the Bedroom

In all cases, counseling and communication is the first step. However, it's not an overnight cure. Communication drops barriers. It's then up to you and your partner to cross the divide in a way that builds trust. Getting back into - ahem - action is a great way to do this.

The physical realities of a wounded veteran's injuries might require some creativity, and alterations to the types of sexual activities you can (and want to) perform. There is a variety of sex toys and aids that can help with the physical mechanics of sex - and the psychology, too.

Erectile dysfunction in wounded veterans may result from injury or psychological hangups. Cock rings can help a man achieve and maintain an erection by constricting the blood flow out of the penis. Another option for a man who has difficulty achieving an erection is a hollow strap-on, where the man places his flaccid or semi-erect penis in the hollow dildo, and is thus still able to penetrate his partner.

Paralysis of the lower body or the whole body can leave veterans assuming that penetrative sex is no longer possible for them. This isn't the case. Depending on the extent of the damage, reflex erections are still possible. Even when the damage prevents erections, devices that strap on to either the waist or thigh can let paralyzed men have penetrative sex with their partner.

Experimentation is recommended for any veteran - and really anyone - who wants to connect intimately with their partner. In cases of traumatic brain injury or spinal damage leading to paralysis, this is highly recommended. The pleasure centers of the brain can connect to different regions of the body, and a wounded veteran can find that they've developed a new erogenous zone, or that they can create one. A bit of tickling or sensory play might just lead to a pleasant discovery.

Positioning can be a problem for veterans with full or partial paralysis, or those that have had an amputation. Really, it can pose a problem for any sort of injury that hampers or changes your body's movement. That's where positioning devices and restraints (yes, those kinds of restraints) can help. You don't have to be into BDSM to get a lot of great use out of these sex toys.

• Spreader Bars can help keep legs in position, and allow a partner deeper access.
• A doggie style strap can be used in many sexual positions, to reduce any strain thrusting might put on the lower back or hips.
• Under-the-bed restraints can help keep either partner's limbs in position and out of the way, reducing the strain of trying to hold your body in that position unaided.
• The Sportsheet, a soft hook and loop sheet with cuffs that can be attached anywhere, allows for greater flexibility in choosing positions according to what your body is capable of, and provides a way to hold yourself in place.
• A door-mounted sex sling can get a wheelchair-using veteran's partner into the proper position for oral sex.

Finally, for all veterans: a reminder that meaningful, satisfying sex requires at least some vulnerability. It's not easy, after being on your guard for so long, to let yourself be vulnerable. Start with communication, and work to bring a little play into the bedroom. For some, that's as simple as bringing in a tickler to bring some laughter back into sex, and joy back into the relationship. Remember that what you loved in the person before deployment is still there (and the same with what they loved about you), and with understanding, communication, and the willingness to be vulnerable you can rediscover it. It may take some outside help to find, but once that intimacy is rediscovered, it can be explored, nurtured, and ultimately grow stronger than ever before.