They were gone for so many years. Now, the relatives of 15 hostages rescued in an undercover mission by the Colombian National Army are facing the great unknown of reintegrating into their families.
Columbian-French citizen Ingrid Betancourt was the first to reunite with her children. Three American hostages -- Marc Gonsalves, Thomas Howes and Keith Stansell -- returned to American soil Wednesday night and spent the holiday weekend recuperating and transitioning back into the lives they once knew.
Psychiatrists say how well these reunions go often depends on a complex combination of circumstances: the ex-hostage's personal history, the age of the family members when they separated, and what exactly happened during the years they were held hostage.
Reunion: Absence and the Status Quo
"People can have a honeymoon effect after a reunion and then problems can develop," said Dr. Spencer Eth, medical director of St. Vincent's Hospital in Manhattan and a professor of psychiatry at New York Medical College.
"Some families heal very well, others break apart," he said. "So much depends on the age and maturity of the spouse and the nature of the relationship before the separation."
If the family was stable with a lot of outside support, the family will often deal better during the absence, said Eth. However if either the parent or the children feel isolated and become depressed, it will have a reciprocal effect on the other family members.
Family members sometimes idealize the missing person.
"Frequently the parent who's missing becomes idealized and that becomes an organizing principle," said Eth. "If things go bad, it's because Dad isn't here to take care of us, or I'm going to do very well so Dad will be proud of me when he gets back."
The disappointment after the real parent returns can be a little damaging: "They may think, 'We've waited for Daddy for so long and now look at him. This is what we've been waiting for?'"
Unlike military deployment or work time apart, a hostage situation carries an extra burden of uncertainty. Children or spouses might go through anticipatory mourning as if the parent is already dead and begin to let go, said Eth.
But many family members manage to survive the separation, and then only have to struggle getting to know the returned parent and change their routine.
"Even in a crisis there's an equilibrium that develops, so that a new routine is established," said Eth. "Then when the parent returns, that status quo has to be changed and so there's a new crisis, a new period of adjustment."
Of all the families who may go through a separation -- through work, military deployment or in immigrant families -- Eth believes the experience of a prisoner of war most mimics the experience of the Colombian hostages.
Coming Home in a Kaleidoscope
U.S. Navy Commander Paul Galanti distinctly remembers his reunion with his wife after 6 years and 8 months in a POW camp in the Hanoi Hilton Complex in North Vietnam.
He was shot down in 1966 and captured. It was 1973 -- two hours after Valentine's Day, with a negative wind chill at the Norfolk Naval Air Station -- when he finally came home.
"I stepped off that airplane after being in the tropics for years," said Galanti. "It was just like I walked into an ice block."
Galanti spent most of his time in Vietnam in solitary confinement in a 7-by-7-foot room with a bucket that served as his toilet. "There were no windows, only had a peephole in the door so the guard could look in," said Galanti.
In the last two years as a POW, he and seven other Americans got out of solitary confinement. Immediately the Viet Cong let the prisoners know their lives were going on without them. One Christmas morning guards came in with a letter for a U.S. soldier. It was from his wife with news that she decided to remarry.
"There was a picture of his wife getting married in a miniskirt … next to this guy with long hair and sideburns," said Galanti. "His kids were young when he left and they were all there smiling."
Galanti says he struck it lucky in his reunion. "I was married, with no kids, thank God," said Galanti. "The ones who had kids had a real hard time when they came home -- they came back and their kids were all into drugs."
Although the culture of the 1970s probably came into play with Galanti's fellow POW families, Eth notes that many children with missing parents tend to act out. "It makes a world of difference if you're talking about a very young child, or a teenager or an adult," said Eth.
Galanti only had to get used to his wife's new personal strength and extroverted personality since he left. That, and all the movement of modern life.
"There was so much input, everything I had not seen on television for years, I hadn't walked more than 3 miles per hour," said Galanti. "It was like a big kaleidoscope in my mind -- all I want is a steak."
The Stress of Everyday Life
Unfortunately, the 15 hostages who came back from five years in the jungle may be at risk when they face that kaleidoscope of modern life.
"A lot of times they'll have trouble adjusting back to normal life because life has been so abnormal for them," said Jan Johnson, a psychiatrist at Tulane University Health Sciences Center and the Veteran Affairs Medical Center in New Orleans.
Johnson could not predict who might develop post traumatic stress disorder or not, but certain factors in the Colombian hostages' experiences could put them at risk, such as the prolonged length of the captivity, or the fact that human beings and not a disaster put them in danger. If any of the hostages had previous traumatic experiences, they could also be at a higher risk to develop PTSD.
"Sometimes the symptoms will appear pretty much immediately," said Johnson. "We've also seen cases where the symptoms appear years later."
In the meantime, Johnson encourages any of the hostages who feel out of sorts to seek help. "PTSD is probably one of our most complex psychiatric illnesses -- it's not something you want to deal with on your own," she said.