Deployments. High operational tempo. War. Constant upheaval from permanent change of station moves.

They all can take their toll on marriage, especially in the Air Force, which has seen an increase in the overall divorce rate almost every year since the wars began, and has had the highest rates of all of the services since 2011.

As of 2013, the divorce rate for enlisted airmen was 4.3 percent and 1.5 percent for officers, according to the Defense Manpower Data Center. The highest divorce rate is among enlisted women, a statistic that has stayed consistent since at least 2001.

Careers and deployment are frequently tied to high divorce rates — a 2013 study by Rand Corp. found a direct correlation between cumulative time spent on deployment and the likelihood of a military marriage failing.

That bears out in an analysis by Air Force Times of marriage and divorce statistics. No matter how you look at the numbers — as a percentage or in actual numbers — some of the busiest jobs in the Air Force have the most divorced airmen.

For example:

■ Security forces airmen, both male and female, had the largest number of people divorced within their career field.

■ Clinical nurses overall had the highest number of divorced Air Force officers.

■For enlisted men, security forces airmen, aerospace propulsion maintainers and client systems airmen top the list, though they also are among the largest career fields. Smaller career fields, such as flight attendants, military training leaders and dorm leaders, show a higher percentage of divorced airmen — more than 10 percent.

■ Knowledge operations management, aerospace medical service and materiel management had the largest number of female enlisted airmen who were divorced in 2013. In smaller career fields, female enlisted defense attachés had the highest percentage at 46 percent, followed by group superintendents and then enlisted aides.

■Male officer mobility pilots had 100 members divorced; cyberspace operations were second highest in number, with acquisition managers third. Academic program managers have the highest percentage at 13.7, physicians assistant second and clinical nurses third.

■Clinical nurses have the highest number of female officers who are divorced, with 234. Personnel officers come in second, and intelligence officers third. Operating room nurses had the highest percentage at 20 percent, followed by flight nurses and then health services administrators.

But there is a bright spot: The data show the numbers trending down since 2011, when the Air Force's overall divorce rate climbed to 3.9 percent — with the worst rates in the enlisted ranks. That year, the divorce rate was 8.4 percent for enlisted women, compared with 7.6 percent in 2013, and 3.8 percent for enlisted men, compared with 3.6 percent in 2013. Divorce rates for officers have declined slightly: From 3.4 percent for women in 2011 to 3.2 percent in 2013, and 1.4 percent for men in 2011 to 1.2 percent in 2013.

Now, the Air Force is looking to keep that trend going with a new program that puts "marriage checkups" in primary care centers. The idea is for doctors to ask the right questions about marital health so they might identify problems before they lead to crisis.

Marriage Checkup

The Marriage Checkup pilot program is being tested at Wright-Patterson Air Force Base, Ohio, and Wilford Hall at Joint Base San Antonio-Lackland, with a goal of taking it Air Force-wide, said clinical psychologist Lt. Col. Jeffrey Cigrang of the Air Force School of Aerospace Medicine at Wright-Patterson.

Through three 30-minute sessions once a year, a psychologist or social worker working in primary care asks questions about the couple's strengths, weaknesses and concerns they might have to help keep marriages on the right track.

"Although couples therapy is better than doing nothing, it's clear that a lot of couples by the time they get to couples therapy, their relationship has been discussed for so long, that therapy may be a little bit too late," said James Cordova, psychology professor at Clark University and clinical psychologist , who developed the Marriage Checkup. His concept was first introduced in 2008 with the publication of his book, "The Marriage Checkup: A Scientific Program for Sustaining and Strengthening Marital Health."

"The decades of research that has been done on relationship variables has really shown this association of how well people are doing in their relationships and all other variables, such as mental health, depression, substance use, anxiety, and more," Cordova said in an Air Force Times interview. "Some of the most interesting associations are the ones between relationships and physical health, for example, so how well your immune system is functioning in comparison to how well you're doing in your relationship," he said.

Cordova said that it's becoming more clear that relationship health is a health variable, and should be treated just like mental health and physical health. And for military members, Cordova said, "unique stressors" like frequent deployments present a challenge far beyond the couples themselves.

"When you go to see the doctor when you're already sick, or the dentist when your tooth already hurts — so we want to be able to get in there earlier at a stage where couples haven't deteriorated as far," Cordova said. "Because if you're getting in there regularly, we can keep you healthier longer."

Finding help on their own

The program might prove helpful to airmen who say they struggle to find support when their marriage starts to fall apart.

A technical sergeant, who asked to be identified only as Patricia to protect her privacy, said she felt like she was all alonewhile she was going through her divorce. She had been assigned to a new base that offered "zero support." The attitude around her was "to just get over it and move on," she said.

"In general, my military 'family' could not have cared less about what I was going through ... As long as I showed up to work and didn't make a suicide attempt, they considered me 'fine,'" she said.

Another Air Force spouse said he too found little support when his wife's deployments and permanent change of station moves started taking a toll on his marriage.

"I was frustrated with this lifestyle, I was having feelings of emasculation and depression, but I didn't know it until I started talking to other guys," Chris Pape said in an Air Force Times interview. He and his wife, Air Force Maj. Dana Pape, have been married 10 years, and after his career kept taking hit after hit with each PCS move, he decided it was time to reach out to other spouses.

Pape founded "Macho Spouse," an interactive website that provides resources and educational videos designed by male military spouses for male military spouses and their families, because he wanted to "help male military spouses connect with one another and try to create some sort of a blueprint to navigate this military lifestyle."

"Once I started connecting with other military spouses, both men and women, I realized that this is nothing uncommon, and once I learned that I wasn't alone in this, I was able to overcome so many more hurdles," Pape said.

Pape launched his website about two years ago. It started with male military spouses talking on camera about their issues and overcoming them, and then he began to incorporate PhD-level experts, along with counselors, researchers, career and financial experts and marriage experts to present "how-to" videos and Skype interviews ranging from specific topics such as spotting a spouse's PTSD, to the importance of communication.

"The content is male-military specific, but we're also giving good solid marital advice overall for both spouses about, for example, communication — before, after and during deployments," he said.

Now, about 40 percent of his website's members are female.

"When I started this site out, I ran some stuff by my wife and she said, 'I had no idea you were going through this, I had no idea that men as a whole went through this,' " Pape said. Female spouses who are having trouble with their boyfriends or husbands are now coming to his site, Pape said, and are telling their significant other to reach out to "Macho Spouse" or reach out to Pape directly. "It's helping the women as much as it is the men," he said.

Alternative support groups helped Ingrid Herrera-Yee, a mental health coordinator and blogger for the Military Spouse Advocacy Network, a website and network of volunteers who empower military spouses and provide them with a stronger support system at their military installations. "Social support is extremely helpful," Herrera-Yee said. "The more support you have around you the more successful you can be in keeping your family and your relationship with your service member together."

Herrera-Yee is also a clinical psychologist and researcher in the Washington, D.C., area, whose exposure to military life started when her brother joined the military. Her spouse is a soldier in the Army National Guard.

"I know I was a part of a women's group when my husband was deployed and it was extremely helpful to talk about everything we were experiencing," Herrera-Yee said. But Herrera-Yee, like Pape, interacts more with her patients or spouses seeking help online. By blogging, through chat groups or email correspondence, she wants to be a resource reachable at any point for fear that budget cuts could diminish support programs on base.

"When people come back, most come back changed, so they really need for this funding to continue," she said. "I could see more spouses and couples and any military member for that matter utilizing chaplains and [Military & Family Life Counseling] members — those are the types of services they could use much more as well as some of the online services and support groups," she said.

Marriage Rx on your flightline

Chaplains have always been a source of counsel for airmen going through divorce or other life-changing events. Airmen are guaranteed confidentiality, and what they discuss with their chaplain cannot be passed on to a commander, spouse or physician, said Maj. David Barns, chaplain with the 56th Fighter Wing at Luke Air Force Base, Ariz.

"Most airmen who come looking for help seek conflict resolution," Barns said. "With us, they have the ability and the freedom to come talk to us without the fear of reprisal by any given means, and that's a significant role that we [chaplains] play."

Barns, who has been in ministry service for the last 20 years, said that he sees more airmen on an individual basis, but does not discourage couples from coming right to him at Luke. And if couples want to move forward, he recommends programs right on base.

"I think the resources we have, whether it be a weekend marriage retreat, or resources through Military One Source, or going to the Airmen Family Readiness Center, various classes, I think they all have their special unique place," Barns said. "The success is really dependent on the couple and the issues that they're dealing with as well to help them restore their healthy relationship," he said.

Programs like Marriage Care, which was designed by Air Force chaplains in 2008 to bring together airmen and their spouses post-deployment, have had more than 5,000 Air Force families participate in the two- to three-day retreat, according to the Air Force Chaplain Corps.

"We sometimes tweak and repackage some of these programs realizing since the beginning of these programs, something could use an update, or realizing something's more effective if applied a different way in the program," Barns said. "But the core of the programs is pretty much the same, still dealing with conflict resolution, communication, still talking about ways to keep the relationship fresh, and to nurture [it] in a positive way."

Barns said that when airmen come to him they may blame deployments on their marriage strife, but that's only the surface of the problem.

"It's the fact that one or both of the spouses feel unloved or underappreciated by the other that becomes the real concern," Barns said. "The deployment just becomes the 'surface level' thing that's bringing about the tension in their relationship. And if it goes unchecked, it affects their communication, it affects their intimacy, and the little problems become bigger problems," he said.

Why are more women divorced?

Researchers are going straight to the source to find out why female airmen continually have the highest divorce rate in the Air Force. Among the questions they are asking: How have changes in gender roles affected relationships? And are other factors such as sexual assault and harassment to blame? 

One aspect being reviewed is the effect of deployments on families, when a mother is deployed and the father is left to take care of the home and children. While many families make that shift with ease, a deployment can put additional stress on some marriages, said Amanda McCorkindale, a former Air Force captain who is a clinical psychologist at Central Arkansas Veterans Healthcare System. 

"When the woman is deployed, gender roles have to shift — she is now the breadwinner, the one in the nontraditional element, and he is now [doing] domestic duties. But if the husband is not able to make that shift, it could eventually lead to divorce," said McCorkindale, co-author of a 2010 study entitled, "U.S. Military Women and Divorce: Separating the Issues," published in the Journal of Feminist Family Therapy in 2011. 

A 2013 Rand study also found a link to divorce and deployments of female service members. "The effect of deployments on a family is much stronger when the woman is the service member," but the data do not yet explain why that is, said Sebastian Negrusa, one of the authors, told Military Times in December. 

If the couple is having problems, a husband may also be reluctant to open up or go to a program, McCorkindale said. 
"Spouse programs are more directed towards women, tailored towards wives, which goes back to the idea to gender roles, which, to me, says there may be more beliefs [within the Defense Department] that these programs were developed for stay-at-home women," she said. "Even though you have the program, it's going to be up to the individual for utilizing that, but it's also to get over that barrier where the husband might think, 'Do I really need to go to a support program full of 30 women?' " 
Another study, "Women Veterans and Divorce, What Are the Contributing Factors?" looks at the cases of 27 female veterans who are divorced, with some saying they were sexually harassed or assaulted and how that might have contributed to their divorce. 

The study, conducted by Air Force Reserve Lt. Col. Alicia Rossiter and Rasheeta Chandler, instructors and researchers at the University of South Florida in Tampa, found a correlation between not getting help after being assaulted and, if the assailant isn't prosecuted, not feeling a sense of vindication, which can put enormous strain on intimate relationships, Rossiter said. 

The study recommends universal screening for sexual trauma to help women reintegrate back into their marriage and family post-deployment. 

Rossiter and Chandler are forming a new survey that will more closely define if a woman's post-traumatic stress is indeed related to sexual trauma, or if it stems from a deployment or a combat-related incident. 
"Our main objective now is to have a larger sample that will produce more statistics that could hopefully have more power and better predict these factors, [and as a result], could get women the help they need," Chandler said.

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