That's where several nonprofit organizations can offer support. The Sanctuary (guardiansanctuary.org), founded by Jon Norsworthy near Washington, D.C., has retreat facilities where veterans come for reflection and a safe place to share their trauma and receive spiritual guidance.

"Most people don't talk about the spiritual disengagement that accompanies PTSD," says Norsworthy. "There are a lot of unanswered questions about how to justify what they've seen with the God we worship. It's not a time for pat answers and clichés."

Marshéle Carter Waddell and her husband, Mark, a retired U.S. Navy seal, share their story of dealing with PTSD through Bridges to Healing, which has worked with more than 100 churches in the last year to provide training.

"A lot of churches are really trying," says Marshéle, author of Hope for the Home Front. "In the last five years, I think the tide is turning. Resources are available now that weren't there before."

Norsworthy says the majority of churches he visits do not have PTSD ministries. "The folks who are doing the most work in helping with PTSD recovery are liberal nonbelievers."

After participating in Bridges to Healing training at Times Square Church, Dr. Bill Butler, leader of the church's military ministry, said, "Most of us didn't realize the scope of the problem and how deep the wounds can affect somebody who's been in combat. It gave us a wake-up call to help serve the military." One of the many services Times Square offers is regular gatherings where veterans can develop friendships and share stories.

Churches in action

Gradually, churches are stepping up to the plate. In April 2008, after learning a young church member became suicidal due to PTSD, pastor Lyle Seger of Wesley United Methodist Church (Hadley, Mass.) co-hosted a workshop for 20 pastors with the Massachusetts nonprofit Veterans Education Project.

The Evangelical Lutheran Church in America (elca) passed a resolution in 2007 to provide a supportive environment for returning veterans and their families, and the elca Minneapolis Area Synod developed The Coming Home Collaborative for those concerned with the psychological and spiritual healing of veterans.

Viet Nam vet and PTSD sufferer John Blehm and his wife, Karen, help teach classes at Skyway Church in Goodyear, Arizona, for those with PTSD and their family members. The church is also planning to bring professional counseling at an affordable price onto the church campus.

But other churches have been slow to respond. For example, Knudsen organized a PTSD training session in Cedar Rapids, Iowa, in June 2008, inviting local churches to hear representatives from the Iowa City VA Hospital, Iowa National Guard, Veterans Affairs, and Point Man International Ministries. Though 60 churches were invited, leaders from only seven attended.

The low attendance didn't surprise Brian Fink, Desert Storm veteran and associate pastor at River of Life Ministries in Cedar Rapids. "Right now this is a very small blip on the radar screen, but I think caring for those with PTSD is going to be the next big thing in church ministry," he says.

That includes big churches. Willow Creek Community Church is in the process of putting together its first support communities for military members and families at their campus in South Barrington, Illinois.

Shadow Mountain Community Church in El Cajon, California, hired Eric Lewis as their first pastor of military ministries in April 2008. Lewis also works with other churches in the region, helping them start their own military ministries.

Complicating matters for churches is the fact that those with PTSD are not likely to speak up about it. "Churches most often find out only after the soldiers have significant problems," says Nate Self, a decorated veteran with PTSD who fought in both Afghanistan and Iraq. (For more on Self's story, see "I Hated Myself" on page 30.)