Veterans deployed to Iraq and Afghanistan during the wars underwent hours of combat driver's training.
They learned to scan roadsides and be hypervigilant. They also learned to speed, disregard traffic rules and change lanes erratically.
"In the beginning of the war, we just drove as fast and as crazy as we could to stay safe without getting blown up by IEDs (improvised explosive devices) or small arms fire," says Will Coulter, a former Army captain who served war zone deployments in both Iraq and Afghanistan.
"When I was there in 2005 we would scan all around the vehicle to make sure there was nothing out of place, and we also had to look for snipers, vehicle-borne IEDs and a huge spectrum of unknown threats that could exist out there," says Coulter. "You had a gunner stand in the middle of the vehicle through a turret with a weapon to deal with any threats you may encounter."
No wonder returning vets have a hard time shutting down the engine when they return stateside.
Back into civilian life
The car insurance company USAA, a leading insurer of those who serve in the military and their immediate families, discovered that accidents in which service members were at fault went up by 13 percent after deployments. Accidents were particularly common in the six months after an overseas tour, according to the review, which covered 2007-2010.
"We have epidemiological data showing that, after a deployment in Vietnam, Gulf War 1 and the recent wars, there is a spike in motor vehicle accident-related deaths," says Eric Kuhn, research health science specialist at the National Center for PTSD Dissemination and Training Division at the Department of Veterans Affairs in Palo Alto, Calif.
That "spike" lasts about seven years. When soldiers come back, they go through what's called a reintegration phase.
"When I came back we weren't allowed to drive for 24 to72 hours because you just got off of an airplane, the time zone has changed and your body is fatigued," says Coulter.
While reintegration driving problems may be due in part to post-traumatic stress disorder (PTSD), traumatic brain injury or anxiety issues, others simply are experiencing reflexive habits, experts say. "I think a lot of it may be a post-deployment natural readjustment that needs to take place. So in the first few weeks -- few months when you return, you're still kind of keyed up -- you're still operating as if you're in the war zone, but overtime you relearn and reestablish your sense of safety on civilian roadways," says Kuhn.
In a reintegration study on Iraq-Afghanistan conducted by Erica Stern, , an associate professor of occupational therapy at the University of Minnesota, 35 percent of combat veterans surveyed reported others have commented about their dangerous driving.
The training pays off, sometimes
Service members are unlikely to face higher insurance rates solely because of past deployments. If anything, they are more likely to see discounts for their military service. Even so, an accident or multiple traffic tickets can drive up rates quickly.
Some vets are more attentive and defensive drivers when they return, so it can swing either way. Coulter is one of the lucky ones.
Coulter, out of the military now and getting his MBA, as well as running a commercial pressure-washing business in Chattanooga, Tenn., says combat driving has only improved his driving. "I do scan the road, not in a bad way, but in my mind I'm always looking at the habits of drivers around me."
"Stress management is another good thing you learn in driving in combat," says Coulter. "Just because someone cuts me off or flips me a bird because they don't like the color shirt I'm wearing, I'm not going to get upset about it. I've learned to maintain a calm, cool, collected appearance."
In combat, "if a car cuts in front of you or a bomb goes off on the side of the road or you get attacked, hollering and stressing out is just going to worsen the situation," says Coulter. He says he now expects cars to cut in front of him; he easily spots bad driving behaviors, and his situational awareness is heightened.
How did Coulter manage to take the best aspects of combat driving and apply them positively once back home when others struggle?
"We have a tendency to study the things that go wrong and not to focus on that aspect, but what we hear anecdotally is that folks feel like their senses are a lot sharper because of combat driving," says Kuhn.
Getting from there to here
In Kuhn's trauma recovery program study, there were differences in reported behaviors based on whether veterans served in Vietnam, the first Gulf War or recent conflicts. Recent returnees reported twice the frequency of aggressive driving.
"There is some speculation that the nature of these conflicts are different than a jungle war or the first Gulf War, which wasn't protracted and they didn't have as long a deployment or multiple deployments," says Kuhn.
What's more, a lot of enemy tactics in recent wars involved guerrilla-style warfare whether it was IEDs or vehicle-borne IEDs or snipers on buildings or overpasses. Much of the traumas occurred in vehicles.
Programs like Palo Alto's PTSD Prolonged Exposure Therapy are making headway in helping those affected. That's where veterans come up with a list of things they avoid (driving on the freeway) or that distress them (driving in rush hour) and rank those situations from least distressing to most distressing. Then they're assigned those tasks as homework until they start recapturing some of the ground that's been lost, using anger management and breathing techniques to increase their comfort with civilian driving.
Other researchers are experimenting with a range of therapies. Dr. Loretta Malta, of the Albany Stratton VA Medical Center in New York, and colleagues have developed a seven-session program based on cognitive behavior therapy techniques. Likewise, occupational therapist Mark Samuel at the VA's Palo Alto campus developed a driving therapy program that takes vets out on the road and teaches them an emotional regulation technique to see how they respond psychologically and physiologically when driving.