Although Posttraumatic Stress Disorder (PTSD) has come to be understood in primarily biological terms, the problems of returning combat veterans from Iraq and Afghanistan (and indeed, of their families) are best understood in psychodynamic terms. Their needs would be better met through a public health model that incorporates progressive outreach and engagement of all new veterans rather than a traditional medical model which focuses only on those with a biological disorder. Work with new veterans and their families requires facilitation of their own adaptive processes (psychological, social, and biological). This approach carries with it the potential to reorient and revitalize the theory and practice of psychiatry.