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A therapist with deep ties to the military community, Dr. Emma Smith writes a monthly advice column for Military.com to address questions from our readers. Want Dr. Emma to answer your question next month? Submit it using the form at the end of the article.
Dear Dr. Emma,
My family’s life is about to change. Dramatically. My husband is being med-boarded out of the Army after 14 years of service. On paper, this was supposed to be a good thing. We’ve been through it all: deployments, training cycles, the constant moving, family drama from halfway around the world. It’s not a surprise. He’s been in pain for a long time.
What is a surprise is that we’re only a few months into the process, and it’s like everything is coming unglued. I knew my husband was struggling physically before, but now it’s like everything is so much worse. Every appointment seems to bring another diagnosis, another thing that’s “broken.” And it’s wearing on his mind. The other day he told me he had to pull over on the side of the road because he had a panic attack about going to his appointment. This isn’t the man I married. I want to ask, “Who are you, and what have you done with my husband?!”
On top of that, I barely recognize myself. I’ve always been the helper. Eldest-daughter energy all the way! The one people come to when things get hard. But lately, I feel cold. Short-tempered. Detached. I look at him and see someone hurting, and instead of wanting to reach out, I just want to pull away.
As if that’s not bad enough, everyone keeps saying this process can take forever. And it already feels like it might break us.
How do you hold on to compassion when you’re running on fumes? How do you love someone who’s changing right in front of you?
Sincerely,
A Tired Army Wife
Dear Tired Army Wife,
Watching the uniform come off is often its own kind of heartbreak, and what you’re describing makes so much sense.
You’re right: On paper, this was supposed to be the “good” outcome. After years of deployments, training cycles, and holding life together from the margins, a medical board can look like relief. But what you’re learning, quickly and painfully, is that med boards are not clean endings. They aren’t retirements or celebrations. They arrive without ceremony, without clarity, and often without mercy.
You’re not imagining the unraveling that you’re witnessing.
As a partner, you sit in a uniquely difficult position. You aren’t the one being evaluated, rated or examined, but you are watching it happen to someone you love. Every new diagnosis, every appointment, every label placed on his body can feel like another quiet theft. Of course it’s terrifying to watch the man you know pull over on the side of the road because his nervous system can’t tolerate one more appointment. Of course it leaves you thinking, “Who is this? And where did my husband go?”
That question isn’t a sign that you’re unloving. It’s an honest and understandable question. And for what it’s worth, he might be asking himself the same question.
What many spouses (and service members, for that matter) don’t realize until they’re in it is that a med board creates multiple losses at once. There are the obvious ones: his pain, his career, his future in uniform. But there’s also what we might call “secondary loss,” or grieving alongside someone whose identity, body and sense of purpose are suddenly in question. And there’s a quieter truth, too: This is a primary loss for you. When you’ve built a life around the rhythms of military service, when your own choices have bent around that structure, its collapse hits you directly. How could it not?
If this feels lonely, disorienting, or overwhelming, you are not doing it wrong.
And let’s be real: The system doesn’t help. Med boards seem confusing almost by design. Timelines stretch and shift. Information is partial or contradictory. The introduction to the VA alone can feel like learning a new language under duress. That prolonged uncertainty keeps both of your nervous systems on edge. It makes planning nearly impossible. And when you can’t see the ground beneath your feet, it’s hard to feel safe, let alone hopeful.
What’s happening to your husband isn’t just physical. Med boards often rupture identity. He isn’t only losing a job; he may be losing a role, a sense of belonging and the meaning he’s carried for 14 years. Many service members silently wrestle with questions like, “Who am I if I’m no longer needed this way?” Shame and moral injury often follow close behind: feelings of letting the team down, leaving others behind or not being “strong enough,” even when none of this was truly a choice.
And here’s the part I want you to hear clearly: Your reaction matters, too.
You’ve been the helper. The steady one. The eldest-daughter-energy problem-solver. When you notice yourself feeling cold, short-tempered or detached, it’s probably a sign of exhaustion and emotional overload rather than a failure of love. Pulling away can be a nervous system’s way of conserving what little energy it has left. I likely has less to do with not caring, and more to do with running on fumes.
Supporting someone through a med board often creates uneven emotional labor. You may be giving far more than you’re receiving right now. That can feel especially jarring compared to deployments or training cycles, where sacrifice was wrapped in a shared sense of purpose. This is different. The story the military tells about service, and the one families internalize, gets disrupted here.
So how do you hold compassion when you’re depleted?
1. You can start by letting go of the idea that you need to fix this. You don’t. Compassion begins with witnessing. Sometimes, the most grounding thing you can offer is simply, “I see how much this is wearing on you.” No silver linings. No reframes.
2. You also get to name what neither of you wanted to be true. Saying, “This isn’t what we hoped for,” or “This is really hard,” creates space for honesty without blame.
3. Expect grief to come in waves for both of you. Progress won’t be linear. On the days when everything feels like too much, it can help to narrow the focus: “What is the next doable thing?” Not the next year. Not the next outcome. Just the next moment that feels within reach.
4. Create something I like to call “micro-anchors” during this time. These are small, predictable rituals that have nothing to do with the military or the med board. A weekly walk. Coffee together in silence. Something that reminds you both that your life is larger than this chapter, even while you’re inside it.
And please hear this: Loving someone who is changing does not require you to disappear. You are not just a witness to this transition. You’re in transition, too. Your sadness, resentment, exhaustion, love and even moments of hope can coexist. If the flow of support feels one-sided right now, that doesn’t mean it always will. But, in the meantime, it does mean you need places to be held, too.
Outside support isn’t a sign that things are falling apart. Therapy (for him, for you or together) can be about healing the wounds of this chapter and also about finding clarity around your values and your relationship as you walk into the next chapter together. Peer spaces with others who understand med boards specifically can ease the isolation. And couples counseling is not a referendum on the strength of your marriage; it’s a way to stay on the same team while everything shifts.
This is an ending that arrived without your consent. It can feel like bad luck, betrayal or being overtaken by forces beyond your control. But this is not a failure — of him, of you or of your marriage. It’s a reckoning and an experience to be endured and eventually healed.
You don’t have to know what comes next. Sometimes it’s enough to stand, together or apart, in the now.
Off the clock, but always in your corner,
Dr. Emma
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24 Comments
The writer’s dilemma of wanting to pull away instead of reaching out to their hurting spouse is a heart-wrenching testament to the toll that prolonged stress and uncertainty can take on relationships.
It’s a stark reminder that relationships require effort and understanding, especially during times of crisis, and seeking professional help can be a vital step in navigating these challenges.
The importance of submitting questions to Dr. Emma’s advice column, as mentioned, can help address the specific challenges faced by military families and provide them with the guidance and support they need.
The medical board process not being a ‘clean ending’ but rather a complex and often merciless process, as described by Dr. Emma, highlights the need for better support systems for families undergoing this transition.
The question of how to love someone who is changing, as posed by the writer, touches on the deeper issue of identity and relationship evolution during significant life transitions like a medical separation from the military.
The writer’s feeling of being ‘cold, short-tempered, and detached’ is a common experience for many military spouses dealing with the stress of a medical separation, and seeking support is crucial during this time.
The lack of ceremony or clarity in the medical board process, as mentioned, can exacerbate feelings of confusion and disorientation for both the service member and their family.
Dr. Emma’s acknowledgment that the writer’s feelings and reactions are understandable and honest provides a reassuring perspective for others who may be experiencing similar emotions during a spouse’s medical separation.
The writer’s concern about the process potentially breaking them is valid, given the already high stress levels and the unpredictable nature of the medical board process, emphasizing the need for proactive support and planning.
The mention of the medical board process lacking ceremony or clarity resonates with the broader theme of military transitions often being marked by uncertainty and a lack of definitive endings.
It’s concerning to hear that the medical board process can take forever, as mentioned by the writer, and its impact on the mental health of both the service member and their spouse is a significant concern that needs to be addressed.
The writer’s struggle to reconcile their role as a helper with their current feelings of detachment highlights the complex emotional landscape of military spouses dealing with a medical separation.
Dr. Emma’s advice column provides a valuable platform for addressing the complex issues faced by military families, such as the one described, where love and compassion are tested by the realities of a medical separation.
The description of the husband’s pain and the impact on his mental health serves as a reminder of the holistic effects of military service and the necessity of comprehensive support for service members and their families.
The fact that the writer and her husband have been through deployments, training cycles, and constant moving, only to face another significant challenge, emphasizes the resilience required of military families and the importance of acknowledging their sacrifices.
The question of how to hold on to compassion when running on fumes, as posed by the writer, is a poignant one, especially considering the 14 years of service and the numerous deployments and training cycles the couple has endured.
The writer’s experience of feeling like everything is coming unglued just a few months into the medical board process highlights the unpredictable nature of this transition and the importance of having a support network.
Dr. Emma’s reassurance that the question ‘Who are you, and what have you done with my husband?’ is not a sign of being unloving but rather an honest and understandable reaction to change is comforting and realistic.
The mention of the husband’s panic attack on the way to an appointment underscores the intense psychological impact of the medical separation process on service members and the need for comprehensive mental health support.
The eldest-daughter energy and the role of being the helper, as described by the writer, can sometimes make it difficult for military spouses to acknowledge their own needs and seek help when they are struggling.
Recognizing this pattern and breaking it by seeking support can be a crucial step in maintaining one’s own well-being during a spouse’s medical separation from the military.
Dr. Emma’s observation that watching the uniform come off can be its own kind of heartbreak is particularly insightful, as it underscores the identity crisis that can accompany a military separation.
This is especially true when the separation is due to a medical condition, as it not only affects the service member’s identity but also their sense of purpose and belonging.
The writer’s description of their husband’s experience with the medical board process, where every appointment seems to bring another diagnosis, resonates deeply, highlighting the complexities of military separations.