"When it got really bad, I dumped 5 tons of sand into my basement to remind me of Afghanistan," Jim told me. "I would just spend the entire day down there in my sandbox, smoking marijuana and working on peace of mind. It made me realize that you can close as many doors as you want, but ghosts walk through walls."

Jim speaks with apparent ease about his war experiences and what they cost him. His stories are punctuated with vivid detail and bemused laughter, mostly at his own expense: How could he have been so naïve ... how could he have failed to see what was going on around him?

He rubs his hands up and down his thighs frequently. It's a kind of nervous gesture that he explains is a result of a spinal injury he sustained in an IED explosion -- his legs still go numb from time to time. "But they don't get numb to the point where I fall down anymore, so I won't complain about progress," he said.

That stoicism is an apt metaphor for the rest of his life, for the experience he shares with so many servicemen and women returning from the conflicts in Iraq and Afghanistan.

It's been almost 30 years since PTSD entered the official lexicon, 30 years in which U.S. combat troops have been continuously deployed in some part of the world or other, churning out a steady stream of psychologically wounded soldiers in need of care. In that time, untold millions have been spent on research, and countless pharmaceutical and therapeutic protocols have been explored.

To what end? In 2008, the Institute of Medicine published the results of a survey -- commissioned by the Department of Veterans Affairs -- of all of the available drug and therapy treatments available for PTSD.

The IOM committee found that "no drugs have adequate data showing efficacy," and it recognized the value of only one therapeutic approach: exposure therapy, a form of psychotherapy requiring a "considerable investment of time, emotion and effort." To that, I would add another requirement: money.

The committee also noted that the vast majority of drug trials were funded by pharmaceutical companies and that many trials were conducted by those who had developed the products.

They were also struck "by the scant evidence exploring some of the possibly unique aspects of PTSD in veterans."

Jim knows all about that. Back when he was spending all his time in his sandbox, he heard blasts coming from the living room upstairs. Sometimes he thought they were mortars. Sometimes mines. In Afghanistan, Jim recalls, "there were so many mines. So many people missing a hand, a leg, an arm -- or two -- or eyes. Out there, entire villages are mined. Mines under stairs, under floors, in walls, just mines everywhere. You really have to be careful."

Six years later, he is still being careful, still working on feeling safe enough to be a little visible in the world after his tour in Afghanistan (which is why I'll just call him "Jim").

On Sept. 11, 2001, when he was just a senior in high school, he watched the Twin Towers fall on TV, skipped classes for the rest of the day, and enlisted in the Army. By the summer of 2003, he was in Kandahar, with "hate, anger and vengeance" in his heart.

One of his first assignments was driving the "jingle truck," a 1974 Mercedes Benz tractor-trailer, covered with garish graffiti, and "with a big-ass American flag on the back." The underside of the truck was lined with chains and bells, so it actually jingled as he drove. "They made me drive all around the circle highway, from Jalalabad to Herat, from Kandahar to Spin Buldak, with one security truck in front of me and one behind. I was bait. I was a human target so the Taliban militants would have something to fire on, so our guys in the security trucks would have something to fire back at.

"I sat in the cab all by myself, blaring rap music and heavy metal, with a box of Cheetos and a bottle of Jack Daniels. And still, I was sure I was doing the right thing."

His next assignment changed his mind. With his dark hair and olive complexion, Jim could pass for a local. He was ordered to grow out his beard, issued a chapan (the vest traditionally worn by Afghan men), a pakol (the traditional Pashto hat), linen pants, leather sandals and a list of phonetically written Pashtun phrases.

So armed, he joined a crew of Afghan trash collectors who worked on the post and listened for talk of insurgency. The crew he was told to infiltrate turned out to be the same one he had been assigned to guard the week before. Of course, the men all recognized him. Instead of treating him with distrust, they bonded over the oxymoronic example of "military intelligence."

"I ended up making really good friends with most of them," Jim said.

And he began to see what it was like for them and their families to be caught up in the war -- the up-close effects of the daily rocket and artillery fire on the villagers, compounded by a foreign occupation force that treats all Afghans as if they were the enemy.

"When I was getting ready to deploy, they were telling us that the Taliban all wore black turbans. But it turned out there wasn't some big gang sign, like the Bloods and the Crips. Other people were wearing black turbans, too. It was messed up. We were supposed to be fighting the Taliban, but we were obliterating Afghanistan."

Jim began taking his frustration and confusion to a Buddhist ascetic who lived in a cave above the Kandahar airfield where Jim was stationed. "

Babah, which means 'honored grandfather' in Pashto, was just a remarkable person. He had this glow about him. When I met him, he was 96. Most of his teeth were gone, and the rest were brown. He was a small man, frail looking, but he was so strong. I think he might have been stronger than me."

Jim often made the trek up to Babah's cave to sit peacefully and drink tea. Babah had been a traveler in his youth. He spoke six languages, told stories of walking from Afghanistan to Tibet through the Hindu Kush and on into Pakistan and India.

And he taught Jim about Buddhist practices and beliefs. Everything Jim learned resonated with the sorrow he felt about what was being done to the country and the people he was coming to know and love.

"I thought we were just doing too much messed up stuff to civilians. It was wrong, and I didn't worry about what people had on their collar, if I had something to say, I would say it.

"But they didn't like what I was saying, so I think that had a lot to do with why Babah got detained.The last thing he said to me, as my brothers cuffed him, was, 'Without suffering, there would be no bliss. Without death, there would be no life.' Even as they put a black hood over his head, he still had his beautiful smile on his face."

His other closest friend was Nasirjan, a member of the trash detail that served as Jim's ostensible cover. Apart from his duties on the post, Nasirjan also raised goats, opium and marijuana, and he took Jim to cockfights, kept him in hashish, and even stood up to gunmen looking to take the life of an American.

One night, when the trash workers were all gathered around the burn pit having tea, Jim gave Nasirjan a keychain flashlight in return for some hash. Narsirjan "was goofing off with the flashlight, and it was really funny because he was a big man and he was being really childish and awkward. We were all laughing when one of my brothers shot him in the back. Dead. He said Nasirjan was trying to signal a rocket attack."

Jim was the one who had given Nasirjan the flashlight, and he believed that he was responsible for Babah's arrest (whatever the facts behind it may have been). He left Afghanistan a month after Babah was taken away, carrying the guilt and the burden of both losses.

Instead of things getting better when he got home, they got worse.

"I already knew that I didn't know how to act anymore," he said. "I didn't know what I was going to do, and I didn't know how people were going to expect me to be."

He was having flashbacks, moments "where I just wasn't even here, you know? I was back there." He drank Wild Turkey all day, only sleeping when he passed out, until one night he didn't recognize his wife. He believes that he could have killed her that night.

The next day, he stopped drinking, and since then has used marijuana to self-medicate, but being stoned didn't make keeping a job any easier. He lost six in quick succession because he couldn't take orders from people who hadn't been where he had been.

That's when he "gave up on society," built his sandbox, and decided he was just going "be this crazy dude and stay in the house for the rest of my life." But being in the house didn't really solve the problem.

"I needed to get to the point where I wasn't afraid of my own thoughts," he told me.

Jim saw six or seven VA doctors after the incident with his wife. They all agreed that he had PTSD and a probable traumatic brain injury. On the basis of those diagnoses, he now gets a disability check from Social Security (but even after three years, the VA has yet to come through with benefits), but otherwise, none of them were much help.

Jim says that's because, "they just think they can tell you what to do and fix the problem. But they can't fix the person with PTSD. Only that person can, because it's a spiritual thing."

Dr. Ed Tick, psychotherapist, activist and author of the award-winning War and the Soul, would agree. He reminds us that the word psychotherapist means "soul attendant," and that psychology means "the order and meaning of the soul." "Psychology," he continues, "did not become a science until Freud and his followers arrived out of the medical tradition. Modern psychology left the soul far behind and has not yet reconnected with its spiritual roots, though it needs to, because psychological healing occurs at a spiritual level."

Jim now sees a Vet Center therapist, also an Afghanistan veteran, "who does a perfect job of making sure that I do help myself and standing behind me to make sure that I don't go backwards. Without him, I probably would still be in the house."

With the new GI Bill, he is going to college this fall. He plans to learn more about Buddhism and meditation so he can teach it as a kind of therapy for other soldiers.

"It's not like the PTSD is gone. Any medical professional would say that I'm the one with the disorder. But if you took me and some 'normal' person, and you locked us in a completely dark room, he's the one that is going to go crazy because I've learned how to be alone in my head.

"I realized I had completely forgotten what Babah taught me -- that there is no such thing as a bad thought. It's just a thought. You can let it go. I remembered why I didn't feel angry or vengeful when Nasirjan was shot. I had completely forgotten for such a long time.

"I still prefer isolation over society, but I can go out now if I need to." He paused before adding, "I couldn't have done that last year."

After eight years of the Bush administration, any attempt to mix science with what might sound like religion is particularly suspect. At the same time, veterans like Jim are pointing the way into uncharted territory.

Jim calls PTSD a "soul wound that has its source in moral trauma." That diagnosis uses a language and a conceptual paradigm that is foreign to Western medicine, with its traditional disregard for matters of the soul or spirit.

But it may be that the only way to better understand the injuries our veterans bring home is to abandon that prejudice and try something new.

Penny Coleman is the widow of a Vietnam veteran who took his own life after coming home. Her Web site is Flashback.