Posted By Thomas E. Ricks Share

This blog is probably not the best place to run this column, because many of you will know instantly what Blake is talking about here. But I am happy to have him start here, and I hope others, outside of those who pay steady attention to our wars, will hear what he has to say.

I am turning the whole column over to him today.

By Blake Hall
Best Defense guest columnist

Every day is a national tragedy. This is not hyperbole. Eighteen veterans kill themselves every day, a figure that represents twenty percent of the suicides in this country, and veterans constitute twenty-three percent of this nation's homeless population. Veterans represent nine percent of America's population, so those numbers, to me, are staggering.

Last month, I sat down for dinner with my former battalion commander. I brought up these numbers and he responded with valid questions, "How much of that is self-selection? Were these vets already struggling with problems before the military? Were they already pre-disposed to engage in high-risk activity? How many of them fought in combat?" I noted that the figures don't include the veterans who kill themselves with alcohol or who kill themselves on motorcycles or in single-car accidents, because those types of fatalities don't fit into neatly quantifiable categories. But, ultimately, I do not have the academic knowledge or expertise to respond authoritatively to his queries. I can only comment on my former scouts and snipers, who call me from time to time, as they fight their demons.

I led twenty-four scouts and five snipers in Iraq from July 2006 to September 2007. Our mandate as a platoon was to kill/capture High Value Targets -- typically Al-Qaida or Iranian backed militants. We were in some rough spots, and, as you can imagine, we saw some terrible things. It affected all of us. As the prophet Isaiah noted, "Behold, I have refined thee, but not with silver; I have chosen thee in the furnace of affliction."

I've had two calls from my men in the last month and a half. One of them was from a sniper team leader I nominated for the Bronze Star with Valor for his actions in combat. The other was from a sniper I consider one of the bravest men in my platoon. Both men told me they considered killing themselves either during deployment or when they returned home from war.

In Mosul, the sniper team leader, "David," rescued the crew of a Stryker Reconnaissance Vehicle taking heavy fire from three different directions. He exposed himself to that fire in order to secure a winch to the vehicle, which was in danger of rolling over into a draw. He saved the crew after he had emplaced and directed his sniper teams to engage insurgents firing four mortar tubes on a combat support hospital -- an action senior commanders credit with saving twenty American lives, for ten coalition service members, some of them nurses, had already been critically wounded at the base from the mortar fire. And then he subdued an Al-Qaida militant in hand-to-hand combat inside of a building.

In Baghdad, another sniper, "Jonathan," was on the rooftop of a building with my company commander during a firefight. Afterwards, the company commander walked up to me with shaky legs and said, "Blake, your snipers are crazy. They were walking around on the roof, bullets everywhere, just pointing and shooting. I was huddled behind the wall taking cover. You might tell them to get down once in awhile."

Both men are brave. I want them by my side in a firefight -- the highest compliment a soldier can give. So it breaks my heart when a soldier like Jonathan calls me and tells me that he wants to kill himself. Jonathan was brave in some of the scariest situations I can imagine, but it is the way that he is being treated now that he is back home that is breaking him down.

When Jonathan returned home from Iraq, he exhibited classic signs of PTSD, a term I hate, for PTSD is a disease that every veteran suffers from to some degree or another. He had trouble sleeping. He was nervous and hyper-alert in normal everyday situations. He couldn't concentrate on a task for longer than a few minutes.

When he went to the chain-of-command for support, he was removed from the sniper section and placed into an administrative role while the command figured out what to do with him. I had moved to the battalion staff, but I took him to lunch one day and he told me, "Sir, I'm not even in the platoon anymore. I feel like a shitbag."

That Jonathan could be treated this way, even by Infantry officers, many of whom have not seen combat to the degree that he has seen it, is unacceptable to me. There is a very real dilemma facing commanders who must decide whether they can allow a soldier to train with live weapons while they are dealing with psychological trauma, but, ultimately, the narrative needs to change. All of us hit lows from time to time, everyone who has experienced heartbreak in a relationship knows how utterly depressing the next few weeks after that cut can be, but, with the help of family and friends, you can make a full recovery and heal.

To understand the current narrative, read this quote from General George S. Patton:

The greatest weapon against the so called ‘battle fatigue' is ridicule. If soldiers would realize that a large proportion of men allegedly suffering from battle fatigue are really using an easy way out, they would be less sympathetic... If soldiers would make fun of those who begin to show battle fatigue, they would prevent its spread and also save the man who allows himself to malinger by this means from an after-life of humiliation and regret.

From the moment a soldier enters basic training to the day he takes off the uniform, he is taught that to admit weakness is to invite ridicule. In The Things They Carried, Tim O'Brien noted how the fear of embarrassment is the greatest motivator of valor. He focused on the negative. Certainly, a hunger for admiration can also enable bravery. But they both center on a certain primal desire for respect we all retain. When I was scared in combat, I knew that I could not shrink from danger, for I would never be able to stand in front of my men again with credibility. So I stood and fought.

We soldiers have been conditioned to never, ever admit we are hurt or suffering. But dealing with the aftermath of war, when you are no longer surrounded by the men who fought with you, when you are no longer working for a chain of command that can give you feedback from a position of authority, when you are alone -- is a battle that far too many of us lose. When some of the bravest guys that I know can't admit weakness, or do admit weakness, and then are subject to ridicule, then I posit that the narrative for the "after," for the persistent battle that we veterans fight for the rest of our lives, should be distinct and separate from the Army's normative weakness -- ridicule relationship that is appropriate for combat.

I told Jonathan that he was brave when it counted. I said that when the chips were down, he faced the bullets and he moved forward, often at the head of the platoon. I let him know that I thought it was far more manly and heroic to admit weakness back here at home because it defies everything we have been taught in our culture that celebrates strength and filters out weakness lest it corrupt the unit.

After a long pause, he said, "Thank you so much for talking to me sir. I already feel a lot better." He shouldn't have to thank me, the nation should thank him. He should feel the respect and gratitude of the country every day by the way he is treated, not just in the popular culture that celebrates America's service members, which all of us who have served appreciate.

Sadly, some of the articles I have read on this blog from the systematic mismanagement and scope creep that have ruined the Army's Warrior Transition Units to single anecdotes about a veteran living alone with PTSD to op-eds that note some businesses are afraid to hire vets due to PTSD and TBI concerns (your article about Obamacare), reinforce the broken nature of the ecosystem of programs design to re-integrate American veterans. David visited a VA counselor three times to talk about the issues he dealt with every day. On his fourth visit, his normal counselor wasn't there, so a new counselor saw him. The counselor asked, "Why are you here?" Then, the counselor sat back and expected David to fill him in on everything that he had already covered with his normal counselor. David got up and left, without treatment, because he got the sense that the therapist didn't care. No one tried to stop him from leaving.

When you go to sleep tonight, eighteen more veterans will be gone by their own hand. Many more will lay their heads down without shelter, because they have lost their way. The thought that one day David and Jonathan could join their ranks is more than I can bear.

Veterans need to know that it is okay to admit weakness after dealing with the trauma of war. They need to know that they won't be judged for opening up about their pain. They need to know that Americans care.

Blake Hall is a former Army captain and a member of the Army Rangers. He led a scout platoon in Iraq from July 2006 to September 2007. His military awards include two bronze stars with one "V" device for valor in combat. He recently graduated from Harvard Business School and co-founded TroopSwap, a platform for the military community.

history.army.mil

EXPLORE:HEALTH, IRAQ, MILITARY
 

JPWREL

10:51 AM ET

July 27, 2010

Tom I think your blog is the

Tom I think your blog is the perfect place to run Blake’s column. Indeed, I would like to see more of such revealing statements. You have a loyal following in your blog of many who have deep military experience and/or family members who are intimately involved in the sharp end of these wars making Blake’s impressions highly relevant. This has nothing to do with being for or against these wars but everything to do with being for our fighting fathers, brothers and sons. Thanks.

 

ZATHRAS

11:06 AM ET

July 27, 2010

Not "Broken"

First of all, I'm not sure why Tom Ricks thinks his blog isn't a good place to run this piece.

It might be helpful if we stopped reflexively using the word "broken" to describe an agency or program that is not working as we think it should. A broken system is one that can't do the things it used to do. What we're facing now is a system for servicing veterans and their health needs that was designed to operate in peacetime, when we didn't have thousands of men and women leaving the military every year after multiple combat deployments. We also, for that matter, did not have thousands of veterans returning after having suffered wounds and injuries that would have been fatal in earlier wars. We have a peacetime system for veterans, and a wartime Army.

The "system" for veterans may have had its shortcomings in the past, but it is the problem it's called upon to address today that is different -- not just a little different, but radically different, and different in a way that will persist for years after the deployments in Iraq and Afghanistan end. The question I have, as a lifelong civilian, is whether it is realistic to expect incremental changes in the peacetime system for servicing veterans to meet the radically different needs so many returning veterans have today.

 

LIGHTNING6

1:41 PM ET

July 27, 2010

Great observation

I think you are right to note that the system is doing what is was designed to do in peacetime. Yet I cannot help but think of my mentor, an old lieutenant colonel, who frequently admonished me: "No decision is a decision too."

Ultimately, this question depends on how you define broken; it is an exercise in semantics. But I think that a system that is so rigid that it does not adjust and re-align with the current need state of service members is indeed broken. Because I am addressing the holistic body of programs and not a particular agency or initiative.

Still, your point about whether it is realistic to expect incremental changes to the existing system to bring out improved outcomes is the one that resonates the most with me. I believe we need to stop scope creep and make sure Warrior Transition Units deal with genuinely sick - whether in body or mind - service members and that they do not also accept a unit's problem children: http://ricks.foreignpolicy.com/posts/2010/06/17/here_s_how_screwed_up_the_army_s_warrior_transition_units_are_genuinely_sick_soldie

Blake

Lumping those two populations together dishonors the soldier who discharged his duties faithfully.

 

HUNTER

11:33 AM ET

July 27, 2010

Great post

Blake brings up some important points and does a great job covering the subject. But he also has a few things wrong...at least under the current understanding of PTSD and suicide prevention.

First of all ridicule isn't the best means of forcing the soldier back to reality. I love old GS Patton but on this matter he was probably very wrong. Sometimes it is effective, but more often than not ridicule and stigma only adds another layer to the problem.

I am finding as I research this problem that soldiers do not fear stigma, they do not fear being called a pussy (esp. since anyone else who has been in the shit would likely never use those terms against a fellow soldier). What they fear is what happened to Jonathan. The fear of letting their buddies down, not being part of the team, not pulling their weight. This is the stigma they fear...that they couldn't do what they needed to to continue doing their job. That they let their buddies down.

The chain of command, in trying to protect Jonathan from harm did almost the textbook WRONG thing in doing so. They took him out of his support group - the platoon - took him away from his job -sniping - and took his weapon away.

The tragedy of all this is that 9 years in we haven't figured this out. But you know who has? Police officers and organizations who go into (potential) combat everyday. They learned long ago not to take a mans weapon from them - unless they need it for forensics, in which case they give them a new one. They learned to do mandatory group and individual counseling after every trauma event. No stigma there if everyone has to talk to a shrink. They learned to do separate tactical lessons learned (AARs) and debriefs (for those not involved in the original action to learn and eliminate rumors and innuendo).

Guess what else we don't do well in the Army...we don't train our soldiers to be physically, mentally or morally prepared for combat. Oh we may train them to be physically fit - but we dont' train them on how to recognize the physiological cahnges that will occur under extreme stress (heart rate, tunnel vision, auditory exclusion, bowel elimination etc.). We don't provde them with any mental preparation (guided imagery, relaxation techniques, visualization). And we don't provide them any moral framework for what they are doing - beyond a lame .ppt on Law of Land Warfare, Geneva convention etc. or maybe some shop talk with the Chaplain.**

We send our soldiers woefully unprepared to deal with the reality of combat, and then we retro-actively slap suicide prevention (ne life preservation) band-aid classes on and wonder why they still off themselves. Guess what? In June, 32 soldiers in the Army (AC and RC) killed themselves. Total for 2010 so far = 140 with between 17 and 32 each month. Hard not to see that they will likely surpass last years highest ever total of 160, by a wide margin when there are still 6 months left in the year.

Every post-action effort the Army has taken has fallen flat. Resiliency training is headed in the right direction, but so much more (as I described) is needed. Combat is life-altering (sometimes even in a good way), some guys will never be saved from those demons. But these numbers are too high, for too long, and yet we flail and fail.

**(Dave Grossman, Loren Christensen, Ken Murray and Alexis Artwohl are all experts in these matters. Look them up and read any of the books they have collaborated on...then put their theory into practice by training your soldiers damnit.)

 

JPWREL

12:05 PM ET

July 27, 2010

Hunter - outstanding reply!

Hunter, I was hoping yours would be one of the responses to Blake’s comment and I wasn’t disappointed, your analysis is outstanding. Let me pose a question: What can be done in pre-deployment training to mitigate the impact of PTSD? I realize the psychological makeup of every human being is different but I really do wonder if there is some ‘preventive medicine’ out there in that would go some way in reducing the effect of the issues Blake talks about?

 

HUNTER

1:56 PM ET

July 27, 2010

Thanks JPWREL

I've alluded to this before. I'm busy writing a journal article targetting this subject...which is why I come armed with the facts. I'm at 27 pages and still just getting started....which is bad news because I probably only get 16 to do what I need to do.

Pre-deployment training...well honestly by then you have missed half the boat. I mentioned alot of what needs to happen. This stuff needs to happen from BCT on. The Army is real big right now on Comprehensive Soldier Health - or some such shit. They are also preaching Resiliency training (which supposedly begins in BCT) which starts to get to some of the mental stuff I mentioned. But they are way behind the power curve.

West Point, that nefarious soul-sucking and dollar ineffective hole on the Hudson (sarcasm), started doing the mental training required here back in 1990 or so. 20 years later the stuff they built is just now making it to the Big Army. Not because their stuff wasn't good, but because Big Army couldn't see the benefit. Some of that USMA stuff became the spine on which Resiliency training rests, but while I did the stuff at USMA, I haven't done the MRT stuff yet so I don't know where the gaps/deltas are.

Physiology and response can easily be taught in a classroom. Example: Soldiers need to know if they piss themselves or shit themselves that 1) its normal 2) doesn't mean they are cowards 3) means they join a long line of other soldiers who have done the same. (one good reason I always shit everything out ahead of time before hitting the road - we called it a "Battle Crap"). That education stuff is easy - you can tell them about heartrate, auditory exclusion, tunnel vision, so they expect it....but what you really need is training. Hard, realistic, SCARY fucking training. Live fire Exercises with killing munitions, and Force on Force exercises with Non-Lethal-Training-Ammunition - places where you get shot and it hurts alot. Not bullshit MILES stuff.

This is when they experience the fear and through stress inoculation learn to deal with it. (Want a great movie scene for this...witness COL Robert Gould Shaw in Glory shooting a pistol behind a soldier on the range). This is hard stuff, time intensive and costly training. But better to do it before combat than experience it first in combat.

Soldiers in my old SQDN came home in late 08, in mid 09 they did Squad Live Fire Exercise. This year, under my successor, they are doing PLT CALFEX (with mortars and fast movers hooah). Guess what, next year they do it for real somewhere in Afghanistan. 10-1 odds says the CALFEX this year will be the single best training they get before they put boots on the ground. Time flies when you are having fun. If your asshole isn't tight doing a live fire exercise then either the exercise is too damn canned or you just aren't doing something right.

Morality training is also fairly simple, but it needs to be done right and done by the right people. People need to understand that in combat they are being asked to do something eminently unnatural - kill another human being. They need to understand that it is unnatural, and that human-human conflict is something we don't easily grasp. People can easily accept that their house was destroyed by a tornado or hurricane, but levels of trauma and horror increase geometrically if another person were to do the same damage to their home. (see Grossman again).

All of this is in the realm of the possible. Police forces do it all everyday - indeed Police forces are the ultimate COIN warriors. They fight the COIN fight all the time. Almost everything I made mention of: physiology training, mental training, trauma debriefs, use of live fire exercises, use of NLTA in force on force, POLICE forces have been perfecting for decades....while we in the military rest on our laurels and wonder why all our joes are sucking on their pistols.

BTW, lest you wonder, the Marines are no better in this regard..."[Army] suicides overall increased by 26 percent from 2008 to 2009, while suicides among Marines have more than doubled since 2005 (Seidman, 2010)."

Here's one more tidbit to chew on - from Finkel's Good Soldiers...I mention it in my draft article:

"It was an insane night," [the company commander Captain] Taylor said.
The final tally: one soldier slightly injured and thirty-five Iraqis dead, including [Sergeant] Gietz's at least seven.
"The men were fired up. They were fired up," Taylor said. "It was an infantryman's dream: close and destroy the enemy."
And maybe so. Maybe it was an infantryman's dream.
But as Gietz said in his troubled voice as he of thought of [his previously injured comrades], and the fact that he and his soldiers had gone to Fedaliyah to capture two Iraqis and had ended up killing thirty-five: "It's a thin line between what we're calling acceptable and not acceptable. It's a thin line. As a leader you are supposed to know when not to cross it. But how do you know? Does the army teach us how to control our emotions? Does the army teach us how to deal with a friend bleeding out in front of you?"
Maybe.
Probably.
"No." (Finkel, 2009, p. 72)

You can never teach everything, but we can teach alot more than we currently do. I hope I can raise some awareness with my article - if I ever finish it. Indeed I hope I piss some people off.

 

JPWREL

2:17 PM ET

July 27, 2010

Your reference to Police

Your reference to Police officers being the ultimate COIN operators is excellent. In fact, I am surprised that the military has not picked upon this theme and exploited the similarities or have they? The difference is that the best cops at domestic COIN have been doing it day in and day out for years to the point that it becomes intuitive. A young soldier/Marine is forced to do it in a different culture whose language and customs he doesn’t know and is rotated out as soon as he develops some aptitude. When you finish this article you must let me read it.

 

SOLDIERSDIARY

3:27 PM ET

July 27, 2010

Police

Police Officers by and large go home every night to their spouses and kids. While I agree that we can take some lessons in how they deal with shootings, I don't know if it is an acurate comparison. While each traffic stop can be the last, they are not doing 12 months of patrols away from family and the stresses that accompany that.
E.G: While deployed, if a Soldier's girlfriend/wife cheats on him, he has the rest of the tour to be angry and stew on it...someone back at home can go to a club with his buddies that night.
Again, I do not mean to diminish what law enforcement does, I understand each traffic stop can be the last.

 

HUNTER

4:12 PM ET

July 27, 2010

That knife cuts both ways

What you have said about police is true. They get to go home pretty much every night. But that knife cuts both ways. They may have to deal with a life-threat or combat during the day and still go home at night and act composed and family-man.

I'm sure any soldier would jump at that chance right?

Turns out not so much. One article documenting what happens at Nellis AF base found that many UAV pilots are struggling with the concept of killing badguys during their shift and then hitting the pool or the kids soccer game on the way home.

Regardless of circumstance, we seem to accept this falsehood that our soldiers will know how to deal with combat...when in fact they haven't been given even the most rudimentary skills in how to do so. Like sheep to the slaughter.

I preached to my soldiers that I didn't want them to do something they later regretted (this was really in the COIN context) - because I didn't want to bring someone home physically well but mentally broken. And yet this is what we routinely do because we haven't taken the time or interest to do the things we must to mentally arm our troopers.

Has to stop now...don't care if the police analogy is imperfect. We ignore their VAST experience to our own detriment.

BTW SoldiersDiary, here's the excerpt from my draft article that addresses exactly those concerns:

Some may object to the comparison between police officers and military personnel - the circumstances are different. Even Artwohl and Christensen make the same argument. Interestingly enough their comparisons, fitting as written in 1997, seem much less applicable today:

...one simply can't compare the life of a combat soldier with the life of a police officer. In a combat zone, the soldier has only one role to fill: that of a soldier. Police officers, on the other hand are not in a combat zone all the time, and they are expected to move fluidly from one role to another, sometimes on a daily basis. In a single day, the police officer may have to wrestle a mentally ill individual, help a homeless person find shelter for a night...issue a traffic ticket to an elderly woman, and survive a gunbattle in a supermarket. The he has to go home and live normally with his spouse. The combat soldier doesn't have to go home to his children and be open to intimacy and communication with his spouse. He doesn't have to try to maintain friendships with civilians who have little understanding of what they are asking him to do for them. He is not expected to be unfailingly polite, effectively helpful, and compassionate to a wide variety of people and their complex social problems during his combat patrols.
The police officer has to maintain effective social and emotional connections with himself and an array of people and situations to function well. But the symptoms of PTSD will prevent him from doing that. The inability to establish and maintain these emotional connections is less of an immediate issue to the combat soldier, who is primarily focused on staying alive and killing the enemy. It will, however, become an issue for the soldier when he leaves the combat zone and tries to have a happy and fulfilling life back in the world.

All this relates back to the different environments police officers and combat soldiers live and operate in. The soldier will not have to worry about facing an internal affairs investigation because he got cranky with a civilian or discharged his weapon. If he shoots someone in the line of duty, he is unlikely to face a criminal investigation, an inquest, or a grand jury, where people who weren't there will make judgments about whether he was justified in using deadly force....Indeed, when the soldier does his job well - kills the enemy quickly and efficiently - he will likely be praised and might even receive a medal or a promotion, sometimes both.... (Artwohl & Christensen).

Artwohl & Christensen's assessment was entirely appropriate when it was written. The U.S. military back then was not expected to do anything other than conduct set-piece battles with tanks and bullets screaming across the desert as occurred in Operation Desert Storm in 1991. Looking back from the perspective of the long counter-insurgency (COIN) based battles being fought in Afghanistan and Iraq, this testimony looks mostly outdated.
Soldiers today are indeed asked to do more than fight and kill on the battlefield. Indeed, soldiers on the COIN battlefield today are expected "to be unfailingly polite, effectively helpful, and compassionate to a wide variety of people and their complex social problems" - furthermore they are often being unfailingly polite to exactly the same people who will be trying to kill them the next day or night! U.S. ground forces do face internal investigations into almost every discharge of their weapons and certainly any killings. Some of those encounters even go to trial as evidenced by episodes like the Haditha courtmartial proceedings.
It is true that most soldiers don't have the luxury, or burden, of returning home each night to contend with their families after a hard day on the battlefield. But even in that regard there exist some interesting exceptions. One article highlights the problems experienced by airmen at Nellis Air Force base outside Las Vegas (Donnelly, 2005). The airmen and pilots are responsible for piloting many of the various unmanned aerial vehicles (UAV) used for aerial reconnaissance. It is a particularly novel aspect of the war, where pilots in Nevada fly aircraft launched and stationed in Iraq and Afghanistan. However, some of the aircraft are also armed with missiles. It is now possible for a pilot to fly a 12 hour shift at Nellis, with scarcely a moment for a bathroom break. Those same pilots may attack and destroy a Taliban enclave before shift change and be off to pick up their children at school before the day is done. One Air Force officer described the challenge:“[Major] Rogers and the sensor operator with whom he works were given the command to shoot the truck. Both developed a case of what Rogers calls the “trembles” – the nervousness of wanting to kill the enemy but injure no one else, combined with the enormity of taking human lives.” Later that day Rogers was at home in the pool with his kids. (Donnelly, 2005).

 

JAMES PHELAN

9:20 AM ET

July 28, 2010

I think you may have

I think you may have misunderstood the post. The author does not support Patton's view on PTSD- he just uses it to illustrate the prevailing attitude. He also agrees with you saying that it was a tragedy that his soldier was removed from his unit and put in an admin position. I don't see where the author got anything wrong based on your recommendations.

 

DEVILDOG0300

10:42 AM ET

July 28, 2010

What percentage is Marines?

I'm prejudiced here but I can't help thinking Marines comprise a smaller percentage simply because we leave Parris Island with PTSD. The three months of stress at PI COULD have a positive effect.

 

TOM RICKS

12:11 PM ET

July 27, 2010

Absolutely

There is a solid body of work on this subject of how to reduce the intensity of PTSD. If I recall Jonathan Shay's conclusions correctly, in his book 'Achilles in Vietnam,' the ways to reduce it are:

--give soldiers good training

--give them good leadership

--above all, establish good cohesion, which might be summarized as an atmosphere of trust horizontally among soldiers and vertically with their leaders, and a sense of a shared future

Best,
Tom

 

ANON

12:14 PM ET

July 27, 2010

For one Lt's unique approach fast forward to the 20 min mark

http://hosted.mediasite.com/mediasite/Viewer/?peid=515ec6b338144a349ed8d5e965e0cc061d

There are no wrong places for Capt Hall's post, just not enough places for it. While there is no replacement for the peer-to-peer relationships for these men and women, simple respect, and to the extent possible empathy, goes a long way. But until we can create a system that identifies with individuals, and not as cogs in the system, we're going to see far too many more lost. Capt Hall is spot on unfortunately.

Right now we're trying to help one of our "guys" who is being forced into Eye movement desensitization and reprocessing (EMDR) therapy by the VA. He hates it. When he did it before it wrenched up every god foresaken thing he's been working to deal with for the last 7 years. It is literally making him sick before our eyes. When one of our "guys" falls of the radar and then comes back in worse shape, it's disheartening. When he tells you HE KNOWS why he is getting worse after years of steady improvment, and the VA refuses to acknowledge him, and in fact will cut off his benefits if he doesn't comply with THEIR treatment plan for him? It's disgusting and heartbreaking. It's exactly as Capt Hall described.

What Captain Hall doesn't go into is that this is a lifelong process. I imagine we will be "checking in" on people for the rest of my years. Only with dedication and persistence will these fights, one at a time be won (or rather reach an equilibrium that works for that soldier, sailor, airman or Marine), and they are not a sprint, they are a lifelong marathon. It will take people like Capt Hall, and (now) Capt Stuckey to help them know that its not only okay to seek help, but part of their warrior ethos to do so, and then to accept that help, whether its just listening, whether its getting in the gym or full on therapy. And that will last long after the last one of them put on their uniform for the last time.

 

JOULE

7:13 PM ET

August 12, 2010

EMDR

Healing doesn't have to take a lifetime. The EMDR that your 'guy' hates accelerates the process and takes you through the muck to the other side in record time...for the right individual. If this is something they are not wanting to do, there must be an alternative treatment that the VA can provide. I am, in fact, surprised to find that they are able to provide this treatment. It has taken ages to convince parts of the military and VA that this treatment would be a good investment.

Having gone through it, I admit that EMDR is intense and you often feel like you are coming apart before you start putting yourself back together again. I would like to hear the rest of the story (backchannel or here).

 

ANON

12:50 PM ET

July 27, 2010

In reply to Hunter

There are people who have identified your very issues, and actually presented programs to the right places, I know the School of Infantry East was given the opportunity, but no one is (yet) willing to alter their training schedule to incorporate the preventive/prep to dealing with the emotional and mental response to combat (and in fact some in the mental health community aren't yet keen to it).

In the USMC, the center of gravity is TBS (and the 0302 follow on next door) and the NCO academies along with SOI/ITB. Get it into their training, emphasize it, and let these NCO's and company grade officers bring it back to their units to share at the squad and platoon levels. Senior SNCO's and field grade officers don't necessarily need to exercise it, just promote and supervise it.

To Tom: I finally read Achilles in Vietnam last year. I should have read it long before that. And if we had an Army and Marine Corps full of Capt Halls and Capt Stuckeys your premise would be fulfilled. But it takes a ton of energy, much of it emotional, to fight the long fight.

 

JPWREL

1:04 PM ET

July 27, 2010

‘Warrior ethos’?? This may

‘Warrior ethos’?? This may be part of the problem. In my humble view the popular almost cartoon like projection directed by the military at young impressionable empty headed recruits to emulate the ‘warrior ethos’ is counter-productive to the point of becoming the theater of the absurd. The over riding theme in the evolution of all military history is that ‘warriors’ inevitably lose in the end to ‘well trained, led and disciplined team oriented’ men at arms. The U. S. military would be better off if it scrapped this make believe ‘warrior’ silliness seemingly based on Hollywood movies. If they want to emulated something they might choose the devastating effectiveness of the Roman legions at the height of their reputation which was based on a fierce discipline, a ceaseless drilling, indefatigable morale and a high order of confidence in themselves and their commanders.

 

ANON

1:36 PM ET

July 27, 2010

@JP

Well if we were fighting battles of the line with sword, spear and arrows, iron discipline, drilling and complete deference to orders I'd agree. Especially since post Marian reforms, if I recall my history, legionnaires were allowed to retire to land and property after an extended period of service, and not expected to be reintegrated into society at the age of 21 with their whole life ahead of them.

In an increasingly fast, decentralized battlefield, I'd rather have an army of creative, trained and motivated soldiers than those of the Roman line. Brothers in hardship and endurance but two very different approaches. Not to mention the COIN benefit of more agile and creative leadership.

 

JPWREL

2:01 PM ET

July 27, 2010

Anon, like you I would prefer

Anon, like you I would prefer to have “an army of creative, trained and motivated soldiers” (in the case of the Army I think that might be more of a goal than current reality) but how does that relate to the historical meaning of ‘warriors’? The bottom line essence for instance of a SEAL platoon’s training is ‘teamwork’ not warriorship. The historical meaning of warriors is centered on ‘self’ and not the team. Warriors could be highly skilled at arms but basically fought as individuals within a group of other warriors fighting as individuals.

 

GOLD STAR FATHER

1:58 PM ET

July 27, 2010

On-Off Switch?

PTSD, an affliction that was recognized back in the Achilles Era, has only recently (post-Vietnam) been taken seriously by the Federal agency mandated to 'deal' with it--the VA. Even after its-quote-legitimacy-unquote was established in the Diagnostic and Statistical Manual of Mental Disorders, the VA fought furiously in Regional Office and Board of Veterans Appeals decisions and even in the Court. It took political decisions of VA appointees, after years of pressure (mostly by RVN veterans) to gain success in service connection for those veterans who are afflicted. Even now, the VA retains an institutional mindset that the veteran must overcome the "guilty until proven innocent" jaundiced eye that the VA adjudicators put on claimants. The new "liberalizing" rule isn't really much of an improvement, contrary to the propogandists and pundits. Stressors must still be granted legitimacy by VBA and now a VA employee or contract psychologist/psyciatrist must make the diagnosis.
Zathras, at the risk of quibbling about semantics and word usage, I have to disagree. The VA is broken if we look upon that agency as the compensation source and more importantly, the medical vehicle to repair our veterans. If the VA was ever a 'peacetime' system, it would be the poster child of failed government. I believe that most all Federal agencies, DOD included, failed miserably since 9/11. I think not that nobody foresaw the load that would be put upon our military ordered to fight 2 basically urban wars in Moslem lands. Nobody can tell me that we all collectively believed, or were lead unwittingly, the Bush Administration position that flowers would be thrown at our soldiers' feet on the roads to Baghdad and Kabul. I vividly remember the Fall of '02 and the Winter of '03 before OIF1. No government agency planned appropriately for anything but a repeat of light causualties and lightening war as we saw in 1990/91. Maybe the VA wasn't funded correctly; but maybe they just fell on their sword and screwed their mandate to care for those that needed their services.
Hunter, I believe that you are right on in your analysis of pre-combat training. We have to all admit however, the military machine isn't supposed to treat their warriors to be released. They treat the warrior to return to the mission. As we have seen vividly over the past nearly 9 years, the warriors are returned to combat time and time and time again.
I have served on active duty, albeit years ago. I have served 23+ years as a veterans service officer. I sent many veterans who needed mental health counceling to VA counselors. When I needed grief help myself when I lost my warrior-son, I cycled through 5 mental health workers, including doctors.
However, the only man who could really save my life was my causualty assistance officer, a USMC senior Staff NCO, who nearly 5 years later remains my loyal crutch--maybe truss is a better word. He will be my friend for life. Bottom line, as others have said, Blake Hall included, it is those with whom one have served who will be the guardians of our buddy's lives. We depended upon them while mutually doing the missions on active duty. It is really only them who we can trust with our lives and psyches when we go civilian. The VA long ago filled the majority of its ranks with non-veteran employees. If one needs help, seek your brothers-in-arms.

 

HUNTER

2:24 PM ET

July 27, 2010

Of course Goldstar

You are correct. We want to return the soldier (I also hate the word warrior but for different reasons than JPWREL) to combat. A bomb to be a bomb must explode (see hopkins in Speed)....a soldier must soldier.

But every soldier eventually leaves the service, so the system must exist that is ready to provide for that soldier. Seek your brothers-in-arms is the best medicine....but I work in the realm of the Reserve Component and we don't live and breathe with our brothers everyday. We go home to communities that don't understand the plight that Blake Hall is trying to convey. We even have wives that try to work together at great distance and often suffer in silence.

So there must be systems, or at least stop gap measures to save ourselves from the nastiness that we have seen or done in name of God, country or comrade. If we aren't ready to bear that cost or burden then we best get our of the war business.

I'm glad that your CAO helped you...it is interesting how many stories like yours I have heard. I'm glad that he could help you with your burden...and yet I wonder how many CAOs or CNOs carry too much burden as well. But that is a different story for a different post.

 

HUNTER

2:33 PM ET

July 27, 2010

Patton redeemed

This is one of my favorite Patton quotes...in many ways I adopted it as part of my Command Philosophy. It supports my previous posts in this thread and informs my journal article:

"… the successful cavalryman must educate himself to say Charge! I say educate himself, for the man is not born who can say it out of hand…. Civilization has affected us; we abhor personal encounter. Many a man will risk his life, with an easy mind, in a burning house, who recoils from having his face punched. We have been taught to restrain our emotions, to look upon anger as low, until many of us have never experienced the God sent ecstasy of unbridled wrath. We have never felt our eyes screw up, our temples throb, and the red mist gather in our sight. And we expect that a man, the result of all this, shall, in an instant, the twinkling of an eye, direct himself of all restraint of all caution and hurl himself on the enemy, a frenzied beast, lusting to probe his foeman's guts with three feet of steel or shatter his brains with a bullet. Gentlemen, it cannot be done - not without mental practice (Patton, 1921)."

 

JPWREL

2:45 PM ET

July 27, 2010

As much of a nutcase as

As much of a nutcase as Patton was there is a strong element of truth to what he was trying to say. Patton's rival Monty, less eloquently once observed to his chief of staff De Guingand that “ . . . our men are not natural killers somehow we must make them so".

 

JIM GOURLEY

5:04 PM ET

July 27, 2010

Of Lepers and Caves

I'm going to say quite a few things that I can't immediately qualify, because the views build on each other. I wish I could give you a clear line of reasoning, but if I could then PTSD wouldn't be a problem. So I'm going to do this the only way I know how-- create the ball of twine and then unravel it. Bear with me.

I am an expert on PTSD. So is every other Soldier/Sailor/Marine/Airman (avoiding diatribes against the all-inclusive "warrior" here) who has felt and/or suffered (because feeling and suffering are distinct from each other) from PTSD. I know we are all experts because no one else does, or can, understand the condition without having gone through it. Army psychologists and counselors who have not felt it or suffered from it only scratch the surface of the problem.

PTSD is very difficult to deal with for two reasons. One reason is the misconception that it is a psychological condition. It's not. It's a spiritual condition. Yes, I know that you cannot anatomically identify the human spirit or sedate it with valium and that, for all its complexities and mysteries, we find the brain much easier to "treat", but I'm telling you right now that trying to understand PTSD under a psychological paradigm is like trying to conduct an ACL surgery at an auto-body shop. I've met David Grossman, and even he speaks about it in metaphysical terms on a frequent basis. If you don't believe me, I'll go dig up the quotes from all the shrinks-in-chief that declare the cause for spikes in suicides in 2008 and 2009 and 2010 was "due to the weather." I give all due respect to the shrinks and counselors. They're doing their best. But with all due respect, their best is nothing but best guesses. Because this isn't scientific. It's spiritual.

The second reason it's difficult is that, even when we acknowledge the spiritual nature of this condition, we are woefully inept at dealing with it. Blake Hall hits on all the things we do wrong-- ridicule, ostracize, and ignore those with the disease. Treat the guy like a leper.

You want to know why we do that? Because deep down underneath all that type-A, testosterone-driven, state-of-the-badass-art Spartan warrior bravado that we exude, we are scared to f---ing death that we'll catch it. PTSD in the Army is like cooties in a third-grade classroom.

If we want to treat PTSD, we've got to do exactly what Blake did. We've got to learn how to hug lepers. We've got to get past the condition and see the man or woman we've always known. We've got to embrace them and hold them tight, tell them that we're here and we're not leaving them. And we've got to mean it. We have to be there. At the office, on the steps of their house, on a swollen riverbank out back of a Chili's on a Saturday night, on the floor of a living room where there used to be furniture at 2 o'clock in the morning. These people don't need us 24/7, but when they do, we've got to answer the call. And we've got to be the kind of leaders and peers that instill enough confidence in them that they'll pick up the phone and call us.

Hotlines and VA administrations can't help. They weren't there in the s--t with you when it was all going down. They don't know. They didn't see. And they don't really care. Yes, I know that many of these people really DO care, but I only know that now. When you have PTSD, you DON'T know that. You certainly won't believe it. Let me back up.

Here's what PTSD is like, and why people kill themselves over it. Think of life like a cave. If I send you into a cave with a lantern and tell you there are no bears in the cave, you feel safe. You will walk around the cave and enjoy yourself. Now what if I give you a lantern and a gun and tell you that there is a bear in there? You can still go down, but you'll be careful to look for the bear and ready to run or shoot if you see it. Now, what if I send you down there with a gun but no lantern and simply say "bear" to you? Pretty soon, you're in there, you can't see the way out, and every rock you bump into feels like a bear. After a long enough time being down in the cave, you realize you don't have enough ammo to shoot everything that might be a bear. It has nothing to do with running out of food or water or feeling like you're fighting some unwinnable battle with the bear. You just get sick and tired of the uncertainty. Are you going to live through the night? Are you going to wake up to a bear gnawing your intestines? You get to the point where you just wish the bear would come along and end it. And when he doesn't come, you decide to do it yourself.

Suicide isn't a surrender, it's a reassertion of power. These guys' lives have spun out of control, and the decision over whether they live or die is the last thing they have the power to determine. Think about it. You ever met a Soldier that wasn't a "take charge kind of guy?" That's my warning bell. I've seen lots of "cries for help" where a guy said "life is meaningless." I don't put much stock in those. But when he says "life is scary"? That's the guy that's going to do it.

So, back to the moment of choice. You've got that gun on your bed or your car keys in your hand and a good cliff in mind. What's going to get you out of that? Some slick-sleeve doc you've never seen before asking you how many times you've been deployed, or a buddy putting his hand on your shoulder and saying "you alright, bro? you look like you're hearing bears."

I'm out with a buddy a while back. We're talking about brands of beer. He hears a car backfire, and suddenly he's scanning ridgelines. He's not here anymore. He's all the way in Afghanistan, and he takes me halfway back to Iraq with him. I think about saying something, telling him that he's here, not there. That I'm with him. That everything is okay. But that would be the wrong thing to say. A couple of minutes pass as we walk. He keeps scanning, I just stay by him. After that, we go back to talking about beer. We don't mention anything about the event.

A couple of days later we're walking along and he says "you know, I really freaked out the other day." I tell him that I know, and I was right there with him. That's all that needs to be said. He knows my story. We don't need any elaborate cathartic rituals or long discussions about it. It's no different than strapping on armor and walking outside the wire. I trusted him to be able to take care of himself, and he trusted me to catch him the moment he couldn't. We're Ranger buddies, not baby-sitters. Giving him dignity and letting him fight the battle on his own is just as important as helping him get up when he gets knocked down.

Our best therapists are our brothers and sisters. The medicine is the very spritual bond of the profession of arms. But you've got to give that medicine in a heavy, constant dose. I'm talking about full-on morphine drip here. When you're in the cave with that bear, you're aware that something is wrong with you. You can't help but feel that. Because of that, you become acutely suspicious of EVERYONE around you. You begin to hate yourself. You have very good, rational reasons for hating yourself. You don't understand why everyone else can't see these reasons and why they don't hate you. Or maybe they do. Maybe they're secretly drafting personnel action memos to move you somewhere else. Maybe they're talking behind your back. It seems like the only people who don't hate you are your wife or kids or parents. Well, it's obvious why. They weren't out there with you. They didn't see. They're all idiots. You start to hate them for not understanding you and not hating you. They keep telling you it's going to be okay and to calm down, and if they say that one more time you're going to scream and wring their necks because it's just not true because so help-me-god-i'm-down-inthiscavewiththisbearandit'sgoingtogetmeAAAARGH!!!

"Jim, where's your furniture? Where's your wife? What's going on?"

"I've ruined my life, Sir."

A Lieutenant Colonel sits down on the tile floor of an empty house beside a sobbing Captain. He's a Brigade XO who's had a long week and only has about a month before he takes Battalion Command and goes to Iraq. His wife is waiting outside in the car and his kids are waiting for him at home. But he takes time for this guy, because he's been down in the cave. He knows this guy is terrified of bears right now, and the Captain might not make it through the night if he doesn't show him there's no bear. He doesn't just refrain from ridicule. He starts telling stories. Stories he'd rather not remember. Stories told in confidence that probably won't be told many more times in his life, but will never be forgotten. That Lieutenant Colonel says lots of things, but it all adds up to one important message.

"There is nothing wrong with you."

He doesn't mean that in a "you ain't hurt, drive on", Patton way. He means it in a very genuine, spiritual way. There is nothing wrong with that Captain because EVERYONE feels that way. We are either all lepers or we're all fine. Either way, there is no reason for that Captain to feel like he's untouchable, outcast, damaged goods. The Lieutenant Colonel chooses to believe we're all okay. On this night, he's successful in convincing the Captain that this is true.

"Is there a gun in the house?"

It's the right question to ask. There isn't one. But the Captain is holding his car keys in his hand and has a bridge in mind. That the Lieutenant Colonel cares enough to ask is all it takes to remove the notion.

"I'll see you at work tomorrow. We'll figure this out-- together."

And that's how my long, slow crawl out of the cave began.

That Lieutenant Colonel said all the right things in all the right ways. You can't train a doc to do that, or write it down in a field manual. You can't teach it to Cadets at West Point or illustrate it on a power point slide. How do you get more leaders to be like that Lieutenant Colonel? The answer, sadly, is that we've got to save as many people going through it as possible, and keep them in the fight. They're the ones who are innoculated against it. They can recognize it, acknowledge it, and help others to fight it. They possess a compassion and empathy no one else can. How do we save the ones currently dealing with it when we have so few who are innoculated? I don't know, but I wish to God someone figures it out. In the meantime I keep watch over my buddy while he watches ridgelines. So much for the extent of my PTSD expertise.

I know how people here feel about Sassaman's memoir, but there was one passage in it that is worth reading the whole book to see.

"A part of me will always be a broken-hearted 40-year-old Battalion Commander."

He says that in reference to the death of Captain Eric Paliwoda, an event that shook him to the core. I suppose it resonates with me because part of me will always be a broken-hearted 26-year-old Captain. I've learned how to keep that part of me from causing the great suffering that nearly destroyed my life, but I still feel it. I feel it every time I see a friend scan ridgelines, or listen to someone talk about watching another human being bleed out and die in some godforsaken wheat field that no one will ever remember or care about. I feel it, and by feeling it I'm able to relate. And while we relate to each other and share the heartbreak, that person is able to breathe easy in the cave, because there's one thing in there that they can be sure isn't a bear. It's another leper holding onto them. Life isn't scary, and it's worth living another day.

 

TOM RICKS

6:27 PM ET

July 27, 2010

Wow

Well said, sir.
Thank you,
Tom

 

TOM RICKS

6:33 PM ET

July 27, 2010

Wow

Well said, sir.
Thank you,
Tom

 

LIGHTNING6

7:51 PM ET

July 27, 2010

context

Thank you for this - what a powerful testament to the impact of leadership and friendship at the crucial moment. We need more men like your colonel. He cared about you and that was enough. And you are right, the validation you sought and needed, could only come from a figure who had credibility that stemmed from his own experiences in combat. To quote you, "we are... all lepers."

Veterans are able to open up to each other because understand the context of combat in a way that no one else can. When I explain combat to friends, I compare it to childbirth. A woman could explain childbirth to me in excruciating detail and I get it. But I don't get it. It's the same way with combat. Unless you've experienced it, you will never grasp the reality of the trauma.

I've found that I'm also able to open to women much more easily about my experiences in combat. Upon reflection, I think it's because a woman doesn't judge my manhood or my masculinity if I admit the pain and trauma I carry with me. Even the slang that soldiers use when we are hurt and can't contribute to the unit, "broke dick", connotes that if you are hurt, if you are broke, then you are not a man. Every soldier will know that phrase.

Yet, I've found that, for whatever reason, I am comfortable confiding in the women who are closest to me and the veterans I fought with. Because I know that I won't be judged for admitting my pain.

Blake Hall

 

KYMAMA86

10:53 PM ET

July 27, 2010

You will never know how much

You will never know how much it has meant for me to read this column by Blake Hall and the response from Jim Gourley. If these two men had been in leadership positions at WWBN-East, Camp Lejeune, at the time when my son was going through his battle with PTSD and TBI, I am positive that the experience would have been completely different.

My son had a similar experience to the one experienced by Jonathan. That chapter of his story was difficult, challenging, and devastating, but it was a “walk in the park” compared to what happened after my son was transferred out of MarSOC and over to WWBN-E. We all thought this would be a positive move and we believed what we were being told....within 90 days he would be back on his team and heading out for his fourth deployment.

I think that all of you would be appalled to know of what is going on at WWBN-E. For the past 18 months, those in leadership have been instrumental in destroying the lives of many Marines, my son being one of them. From what I’ve been able to gather, much of the problem comes from NCO’s and officers at the company level, but when the command is informed and does nothing but look the other way, it becomes a completely different and additional problem that must be solved. I finally had to get involved when my son’s life was at stake. I carefully documented everything before I went forward with my concerns. I honestly thought it was one bad leader who just needed to be set straight. After a year and a half of fighting the system, and bringing this to the attention of every level in the chain of command, I finally have realized that it is the entire system that needs to be fixed...not just one lousy leader in one battalion.

I read this blog all the time. It is the comments that interest me most. It’s apparent that many who participate here are officers and I have found it extremely educational to gain your perspective and to get a tiny glimpse into how officers approach and solve situations. It has helped me to understand more of the WHY when it comes to leadership issues at Camp Lejeune.

As long as the units for our wounded troops are being run by those who are in the business of building war machines, this problem is just going to get bigger and bigger. Please spare me the “accountability” response that is always the premise for any leadership decisions being explained to me. Frankly, I’m really tired of hearing that excuse.

Jim said, “Blake Hall hits on all the things we do wrong - ridicule, ostracize, and ignore those with the disease. Treat the guy like a leper.”

That is exactly what is happening, and yet, when it is brought to everyone’s attention there might be one person that will actually admit that it’s true. EVERYONE is scared. They are scared NOT to run the ship like it’s always been done. Fear guides every action and every decision being made at WWBN-East. Fear guides the leadership and their actions instill fear in the patients. If you knew all that I know, you wouldn’t be surprised by the fact that the Army lost 32 soldiers to suicide in June. What surprises me is that 32 Marines at Camp Lejeune’s WWBN didn’t do the same.

I’m doing everything I can in my community to make this a better place for returning veterans. My organization is developing a program for vets with invisible wounds. I would be very interested in using portions of Jim’s statement in the materials I’m creating to present to our seasoned veterans. We are setting up a mentoring program with older vets reaching out to help younger vets. The Lt Colonel that Jim referred to is the type of man I’d like to see involved in our program. It won’t surprise you to know that many of the younger vets are thrilled to have an option other than the VA to talk about their problems and get the support they need. We are also trying to set up something for families because there are a lot of us out here who are casualties of secondary stress.

I am nobody important, but I’ve made it my number one commitment to do everything I can to make a difference in the lives of those struggling with PTSD and TBI. I haven’t been to combat. I’m not a doctor. I’m not a counselor. I’m a Marine mom who has been deeply hurt by the wounds my son received from his own. I’m a mom who believed in the Corps as much as my son did. We fully expected to see the motto, Semper Fidelis, being lived out, especially by those at the battalion for the wounded. Once-shy, I am now outspoken and ready to take on anyone who is going to continue to shove these issues under the rug. I can promise you that my son’s life, as well as the lives of those I’ve met at WWBN are worth every minute of this fight.

If you agree with Jim Gourley’s post, “Of Lepers and Caves”, I ask that you take a few minutes and read my blog entries. (http://www.fellednot.com/apps/blog/ ) It may take awhile to read them but it should open your eyes to the devastation experienced by countless families across the country.

As Blake said, “When you go to sleep tonight, eighteen more veterans will be gone by their own hand. Many more will lay their heads down without shelter, because they have lost their way. The thought that one day David and Jonathan could join their ranks is more than I can bear.”

I’m not sure how much longer I can bear it either. I’ve been to numerous military funerals, but there are three Marine funerals that will always provoke the most painful memories. Two of these funerals were within a week’s time, just this month. The cause of death....PTSD’s reaction to poor health care (aka...suicide). If this issue hasn’t personally knocked on your door, it won’t be long.

 

LUVMY91STANG

1:44 AM ET

July 28, 2010

Excellent

Probably the best summary of PTSD ever. The only people who understand what soldiers go through are other soldiers who have been there. My dad had horrific memories from the Korean war. He was a machine gunner in his outfit which was rushed over from Japan right after the North invaded, fell back into the Pusan perimeter, and was there for the breakout. But in those days there were organizations like the VFW. Say what you will about sitting around the bar at the local VFW post telling war stories, I'm convinced it was beneficial for soldiers to be around other soldiers who had been there, done that, even if the worst war stories were never verbalized. It was a shared experience, and knowing it was shared helped with coping.

 

JPWREL

6:51 PM ET

July 27, 2010

The question not asked

The subject of Tom’s blog today has been one of the best I have read in quite some time. Blake Hall’s commentary was not only moving but opened the door to a lot of questions at least for me and the response has been superlative. One question that no one yet seems to have touched on is how about all those soldiers, Marines, and Special Op’s guys (perhaps the majority) who have the same experiences as those afflicted with PTSD but don’t exhibit the symptoms or have very mild symptoms. What is it about their psychological or spiritual make up that that has sheltered them from this syndrome?

 

JIM GOURLEY

9:00 PM ET

July 27, 2010

No Answers, But Some Anecdotes

What is it about their make up that sheltered them? Great question. You could write an encyclopedia with the answers. There are many. Here are the ones I found.

There are little windows that allow us glimpses all over the place. I found several in books. "Deep Survival: Who Lives, Who Dies, and Why", by Laurence Gonzales. The book opens with an explanation of why some Navy pilots put the bird on the deck and others slam into the back of the ship. It only gets better from there. I'm sure everyone's familiar with Pressfield's "Gates of Fire." It may be fiction, but when Pressfield's Dienekes talks about "Phobos", you can't find truer words. Grossman is always good.

Despite the psychological content of Grossman and Gonzales, I stand by what I said about the spiritual aspect of the condition. Here's how it worked for me. My last panic attack was in 2008 during the Presidential debate. Long story, but Barack Obama caused me to have a panic attack. I'm not joking. Nor am I joking when I say that it was the best panic attack of my life, which is why it was my last. By then I'd re-read a lot of Grossman's stuff, read Gonzales, and discussed a great deal of it with a friend of mine who's a shrink. So, there I am, hyperventilating, breaking out in a cold sweat, doubling over and frothing at the mouth, and despite all appearances I'm doing okay. Because inside the contorted physical exterior, my mind is saying "okay, we know what this is. We are initiating a reflexive physical response to a perceived threat that doesn't actually exist. The lower brain has run away with our body and is spazzing out. However, this time we have been able to maintain higher thought processes and rationally process what is going on instead of streaming live video feed of all the horrible things we saw in Iraq through our head. This is a good thing."

I'm not sure if all the understanding of what's happening in my brain was really necessary. What was ABSOLUTELY important is that I established a relationship with the event such that I maintained control. I gained an understanding of the thing such that I no longer felt a reason to fear it. Because I no longer feared it, I could deal with it. I could have established that knowledge by any number of methods. Some guys only need to read the field manual once. Some guys have to do rock drills. Other guys need to see it done. They still learn the same battle drill. "I'm having a panic attack. Be cool. Ride it out."

I think another major aspect is having an outlet. I turned into a smoker like no other for about the first four months. When I quit, I took up triathlon. Not the smoothest transition ever devised. I worked up to Ironman distance and I'm still hooked. I found something really strange along the way-- there are lots of others like me. I haven't been able to find enough folks who'll give me interviews to accumulate compelling evidence, but I'm convinced there's something to it. There are plenty of people out there who think you've got to be crazy to swim, bike, and run 140.6 miles. I think that may actually be true. Ironman was invented by a bunch of military guys, after all. What in the world compels people to do it? Why go that distance? It's not all about the finish line. When you subject your body to that level of punishment, you go somewhere else deep inside of you. You can't finish unless you do. I think that's the ultimate reason people do it. They're not there for the finish-- they're there for that moment when you just want to quit, where you have to fight against your own body and conquer your urge to give up in order to reach your objective. Why do so many amputees, burn victims, and other combat injured and disabled ride bicycles across the US, or run marathons, or tackle other endurance events? Because it's about endurance. They're enduring something. For them, it's part trial of their ability to overcome their challenges, part celebration of their recovery, and part journey inward to learn something about the new person they've become.

Maybe for some people it's boxing or MMA. For others it might be team sports. But I think it's important for people to get into something where they can put themselves back in the fight. Go do something that's going to knock you down, just to prove you can get back up.

With regard to who makes up the majority of PTSD cases, I've seen conflicting reports. One said that Intel personnel make up the majority, with the causal factor being all the photos they have to look at of bodies. I had a friend that watched videos of a reporter being beheaded over and over for about two days straight while he was trying to figure out the location. That and a concussion messed him up. Another report said that logistics personnel have it the worst because of all the ambushes they meet driving on the roads and the concussions sustained from IEDs. However, your combat arms crowd is going to be the demographic most at risk to avoid reporting due to the ridicule factor. So the statistics are probably skewed any which way you cut it.

Support groups are paramount. ODAs and SEAL teams are tight-knit. Even when you PCS you're going to meet someone you know. The big Army isn't as personable all the time.

This one's probably going to be contentious, but I'll say it. A sense of confidence that you're doing the right thing is important. Look at the legions of Rome and Alexander. After those guys got done hacking Persians and Huns to pieces with bronze swords and pulling their heads off with their bare hands, they came home to massive parades where the citizens showered them with rose petals. They were revered. They held special priveleges as honored members of society. When they came back from Vietnam? The rose petals turned into rotten tomatoes. As for the warrior's place in modern society? Joining the Army is something you do if you can't get into college. As for popular support, well, we know how that is. It's kind of hard to reconcile your conscience over drilling some guy you never met in the face with an automatic weapon when your country can't even reconcile within its electorate the justification for sending you into said guy's house in the first place.

I've never seen a sore winner. It's a lot easier to deal with your actions when they aren't painted by defeat. I'm not saying that we lost in Iraq, or that we'll lose in Afghanistan. But I don't think that, no matter what happens in either country, Americans will ever FEEL on a national level that they won. It kind of sucks when you start a 12-month deployment knowing that nothing you do is going to change people's perspective for the positive. "I'm wasting a year of my life" is a crappy outlook to start the day with if it's going to end with you killing another human being. If it's a waste when you get out of bed, what is it by the time you're back in the rack?

As Clausewitz said, "the moral elements are most important in war."

That reminds me. I forgot another important quote in my previous post. My favorite general, Sherman, once said:

"Grant stood by me when I was crazy, and I stood by Grant when he was drunk. Now we stand together."

 

HUNTER

9:05 AM ET

July 28, 2010

Slightly OT

Jim,
If you like Ironman may I commend to you Born to Run by Chris McDougall. I just finished it and it is a really great non-fiction book. I read an enormous amount but I can't get this book out of my head. It speaks to that overcoming and enduring spirit.

 

GOLD STAR FATHER

7:56 PM ET

July 27, 2010

Thanks Jim

Jim, your post, without question, is the most articulate presentation of the subject that I have ever seen. Your words will assist hundreds.
JPWREL, those that have been in the heavy shit will never be sheltered from the experience. I have seen an amazing number of VN veterans who become symptomatic after they retired. Life, a good life, has kept "things" away in that special compartment. Age and slower life functions release the bastards. PTSD doesn't always surface immediately post-incident, post combat, or post-deployment. As others stated earlier, this is a lifetime deal, both for the afflicted and for brothers and sisters who will stand by.

 

JPWREL

10:07 PM ET

July 27, 2010

I have a suspicion that PTSD,

I have a suspicion that PTSD, shell shock, combat fatigue; whatever name you want to apply to it is largely a feature of war beginning in the 19th century. Obviously, I don’t know that as an absolute fact but it seems to me the civilizing features of our era have done much to alter our psychological or as JIM GOURLEY says our spiritual relationship to the consequences of lethal violence. I wonder if Caesar’s Legionnaires ankle deep in gore butchering Vercingetorix’s Gallic tribes at Alesia or the British Guards mowing down with musketry Napoleon’s Imperial Guards at Waterloo were confronted with a challenge to their mental equilibrium? In August 1758 the 42nd Foot the Royal Highland Regt. ‘The Black Watch’ stormed the breastworks of Fort Carillion (Ticonderoga) received a horrific slaughtering yet went onto further superb service in a particularly vicious and brutal war and the many first hand accounts of that regiment’s service do not mention lingering mental distress.

 

JIM GOURLEY

5:54 AM ET

July 28, 2010

The Speed of Combat

JPWREL,

I think some things about modern combat do indeed change the psychological relationship. Alexander's legions had to march for weeks or months all the way back from Afghanistan to get to Macedonia, or they married a girl there and became permanent residents. Our guys get on a plane and are sitting in front of the TV with their wife and kids in less than 96 hours.

Guys at Antietam and Cold Harbor sat down by campfires after sunset and shared the warmth of their comaraderie and a flask of Tennessee whiskey before the next day's fighting. Our guys turn on the TV or head to the MWR shack and write e-mail. GO #1 keeps hooch out of theater.

Battles prior to WWI were usually single, set-piece engagements that decided things in at least a theater if not the whole conflict. Today the combat resembles the getaway scene in 'Heat'-- a continuous running gun fight that doesn't seem to have a clear outcome.

I think there was greater moral clarity back then, as well. I'm not saying anyone was more righteous according to the principles of Walzer, it's just that they knew what they were about and were comfortable with it. The Samurai, the Legionaire, the Jannisary, they were all fighting for *the* right cause and no one could judge them. Today, the situation is very confused, and everyone judges the Soldier-- via satellite no less. The Rolling Stone article on McChrystal demonstrates that. There's the commander, our version of Alexander in Afghanistan, and he can't convince his own troops that the ROE is right. It's not that they think they have the right answer, rather that they haven't seen anything that looks right. Far from saying "this is wrong", they're telling us that they don't even know which end is up. So right off the bat their combat environment is that dark cave I was talking about, and we've robbed them of their lantern. We've accelerated their progression toward every rock becoming a bear.

The advent of greater standoff due to increased weapons range has something to do with it. If a guy's coming at you with a sword, that's one thing. Yes, it's terrifying and gruesome, but you can morally resolve that. Combat almost becomes a mass action of self-defense. But think of all the stories of snipers who just couldn't pull the trigger at various times for whatever reason. It's hard to make a guy's head explode while he's lighting a cigarette. When our guys have seen enough intel reports to know the guy in their sights burying an IED is more likely a dirt-poor farmer just trying to feed his family than a stone-cold insurgent, it's hard not to feel a degree of sympathy.

I wonder how much entertainment technology has changed things. Grossman has written reams of polemic against the use of combat-themed video games as mass entertainment. If you haven't seen videos of the new "Modern Warfare 2" game, check it out. When you fly a UAV on that game, IT IS REAL. I've never seen anything so sophisticated in its simulation. Now, take a kid who's been playing games like that since he was fifteen, shove him out on his first combat patrol, and get him in a firefight. Is he more or less prepared? Did the game do him a tremendous psychological injustice by falsely convincing him how "easy" it is to fight and kill people?

When I was a PL in 2003, we'd run convoy escorts through Mosul, and then the guys would come back to our base and play "Grand Theft Auto". I couldn't help but think even then that there was very little difference between their work and their play. They never turned their minds off to it. They were "plugged in" 24/7. Road rage around Fort Campbell is infamous.

I don't think technology is bad. I do think that, like our military strategies and operations, we don't give enough consideration to what the second and third order effects will be. We've been in such a rush to "fix" this problem for so long that I think we're probably dealing with 20th-order effects at this point. That will take a lot of thinking. No, we can't go back to flintlocks and phalanxes, but there are some fundamentals we can revive. Kick company commanders off their laptops and let them run their companies. Stop thinking you need daily CPOF-hosted intra-theater broadband powerpoint circle jerk sessions. Get your head out of your computer and go look your troops in the face. The machines were supposed to automate things, that means they should be able to run themselves for a bit. Go out there and lead your people. We should be able to afford to do that. The Taliban has about 1/1,000,000,000 of our technological capacity, and they seem to be doing just fine.

 

KYMAMA86

10:14 AM ET

July 28, 2010

Go look your troops in the face!

Jim, I hope someone with power and influence is paying attention to your posts. You continue to make more sense than anyone in leadership I've spoken to about this problem.

You have taken the time to UNDERSTAND the problem and view things from more than just your own perspective. Until everyone else in leadership is willing to do that, I don't think this problem can be solved.

"Kick company commanders off their laptops and let them run their companies. Stop thinking you need daily CPOF-hosted intra-theater broadband powerpoint circle jerk sessions. Get your head out of your computer and go look your troops in the face."

Might I add.... commanders would you treat your own child in the way you treat your troops? If the honest answer is NO, then you need to reevaluate immediately.

 

NORWEGIAN SHOOTER

11:59 PM ET

July 27, 2010

I agree, everyone should know this

Thanks Tom and Blake. Two questions:
Does knowing this cause anyone to decrease their support of keeping the current level of troops deployed?
Who are the current Tim O'Briens?

 

LIGHTNING6

2:42 PM ET

July 28, 2010

Sharing the burden

I feel uncomfortable coming back to a mainstream society that does not feel like it is engaged in or pulling their weight for the war. I think part of this is a leadership issue, the Bush Administration did not even put together a War Bond effort that could have increased national participation and engagement that would have allowed people to express their patriotism by providing resources to troops.

When we returned home from Iraq after we were extended, my recon platoon sergeant had seen his wife and children for 18 out of the last 45 months. Think about that. He was married to his high school sweetheart and they had four kids. Think about all the missed birthdays, the missed Christmases - not to mention that one of his boys nearly died from a staph infection while we were in Mosul. And, when he found out, the docs told him they would know within 24 hours and he couldn't make it home it time even if the military flew him out.

It's not fair. It's not fair to me that the most selfless community I know is asked to deploy over and over and over again while everyone else grabs their skim lattes and goes to work in a nice air conditioned office. And that latter community now includes me.

Just prior to 9/11, my military professor, a light colonel, told my class that during the Cold War, the professional Army was designed to be a "speedbump" to hold the line while America summoned her resources to surge and win the war in a decisive push - sort of a two-phase plan to apply the Powell Doctrine.

Well, men and women better than I have held the line for nine long years. I served for four years on active duty, 15 months of that in combat, and I served two years as a reservist. But my heroes are the men and women who deploy again and again and again.

The dedication to go to war when so many express apathy; the persistence to stay the course when so many are ready to quit; the selflessness to give your life for a faint hope of victory; I stand in awe of the American spirit - the warrior ethos that some disparaged on here. American are winners, but more, our modern warriors display compassion and provide medical aid to our sworn enemies to a degree that no other Army that has walked the earth before has done. The Battle of Zarqa shows how quickly we can change gears. I get chills when I think I am part of a new class of warrior. As MacArthur noted, 'The soldier, be he friend or foe, is charged with the protection of the weak and unarmed. It is the very essence and reason for his being."

It is a testament to the men and women in uniform that, after all of the strategic mistakes in Iraq, after all of our individual loss and suffering, that this war is largely devoid of any war crimes. Abu Ghraib was perpetrated by civilian type support soldiers, not by the warriors. I consider it a great honor to have my name counted among those who compose such a professional Army.

The O'Brien's are out there. But a great work of fiction will probably not develop until it can communicate to a historical narrative that is fairly certain. And right now, the outcomes of the wars in Iraq and Afghanistan are far from certain.

Blake Hall

 

NORWEGIAN SHOOTER

12:56 AM ET

July 29, 2010

Again, thanks.

I think the writers are out there too, although I hope they don't wait for or follow "a historical narrative that is fairly certain." Another thing I just thought of, many writers will be found among Iraqis and Afghans. Who are the Vietnamese, Hmong and Lao writers of the American War?

 

SOLDIERSDIARY

12:51 AM ET

July 28, 2010

Tim O'Brian

Shooter; so far, though this war has produced a ton of non-fiction, history and memoirs, I don't think a great work of fiction in the form of a Mailer or O'Brian will be produced.

 

J.D

9:33 AM ET

July 28, 2010

leadership in "complex environments"

lots of talk around DoD, think tanks, school houses, etc about the "complex environments" we are operating in.....well.......Ft Riley, Ft Bragg, Ft Hood, Ft Campbell, etc are all also extremely "complex environments"....with unique leadership challenges that our Army and Marine Corps has yet to get it hands around after years and years of unyielding deployments.....we need to attack these complex environments with the same rigor and resources as we do the overseas complex environments....

 

TOM RICKS

9:55 AM ET

July 28, 2010

a great discussion

I just read over all the comments again. I want to thank you to all who contributed. This is the sort of thing I hoped for when I began this blog. I learned a lot.
With gratitude,
Tom

 

JRHAMP

10:54 AM ET

July 28, 2010

An Excellent Piece..A Prespective

Unlike World War II and the hundreds of movies we all have seen, Iraq and Afghanistan ..and perhaps Vietnam... are very different in many ways.

WWII was about evil versus good; about black versus while; about the "good guys" and against the "bad guys".

In 2009, at the 65th anniversary of the invasion of Europe..at the cemetery along the cliffs of Normandy looking at the Roosevelt brothers headstones where each is buried side by side... an aging British former soldier of WWII and his wife walked up to the grave site.

Many of you may know, President Terry Roosevelt lost two sons.. one son of died in WWI in France while the other died 30 days after the invasion of Europe..both a side by side not far from the overwatch to the beaches where thousands of soldiers stormed on that day of June 6th. Where men waded head long into a wall of lead by the infamous MG-42 belt fed machine gun.

As I gazed with an historical perspective to it all...the WWII British soldier adorned in a blue blazer with medals and a beret remarked..."World War II was truly a soldier's war and there has not been on since..." So true, I replied.

Perhaps America's war since WWII are not "good versus evil", but rather a mix of military objectives enmeshed in a mix of political objectives.

Soldiers today like those of WWII..want to see their sacrifices "worth something"..to have some meaning to it all.

Justifying it all is impossible...all one can do is to say.." I did my best" for my unit and for my buddies and press on with life like so many did after World War II, Korea and Vietnam.

Although, many Vietnam veterans continue to ask "why" and are haunted by it all..many of the 2.2 million men and women who served what still is America's longest war went on to be productive individuals who found their way back into mainstream American society.

So, for those who say "why"..there are perhaps no answers..and for those who lived along side those who did not..we owe to those who did not return to do the best we can both for ourselves, our families and for those who will always remain in our memories.

Because for those who never experienced what so many experienced in Iraq and Afghanistan..the glory is only for those who can now "talk the talk"..because they truly.."walked the walk".

RH/BiH,Afgh/Iraq/HOA

 

JTG-C2-3

10:58 AM ET

July 28, 2010

Well Written as Always

Blake, well written as always brother. Breaks my heart to know this all is going on. I know one of the things that motivated me to join was that I didn't want our generation of warriors to go through what my father's generation went through during and after Vietnam. It wasn't till 2004 when the Traveling Vietnam Memorial came to our hometown before my father said he truly felt welcomed home from the war. He told me that the weekend I commissioned and I almost felt ashamed that I lived in a nation that would allow that to happen to one, if not all, of its veterans.
When we came back I experienced, as I’m sure we all did, that euphoria of being home, before that could end, I moved on to TRADOC and was soon so busy that I really didn’t have time to sit back and evaluate how the Army, the DoD, and the nation was doing at accepting and caring for its veterans. Now I’m out. I’m surrounded by a bunch of spoiled, snot-nosed law students who I get along with, but at times have little patience for. I spend most of my time with three Marine vets that are in my class and we share many of the same concerns. Though I am glad our vets don’t face the animosity of the Vietnam-era, and the VA and DoD at least facially acknowledge the issue of the mental wounds suffered by service members, it seems as though the by and large response to veterans is indifference. In that indifference, I believe lies the root of our nation’s problems identified by your article.
First, it seems like there is a widening gap between the values that our volunteer force upholds and society at large. Many service members feel they embody the hard-working, initiative-driven ethic that made America great, while the people are self-indulgent, celebrity-obsessed, spoiled-brats. Whether this gap is as wide as it seems at times, the perception of it is still there and I’m sure the individuals your article speaks of view it at its widest.
Secondly, the general American ignorance of the military and the different specialties greatly frustrates the combat arms members of the Army and Marines. I believe that has the effect of further alienating those individuals who are exposed to greatest amount of tragedy and hardship. I by no means discount the exposure that support troops have to combat and tragedy on the non-linear battlefield, but the differences between branches and MOSs has to play a role (of course I don’t have support for this claim, but I bet it’s there). We were exposed to it in theater and it seems to be a universal truth from every vet that I’ve talked to: in Iraq and Afghanistan, there are two wars being fought. The one on the FOB; and the one out in the battlespace. I’m willing to bet that every time they show service members at a USO event or in a cut away from a football game or other pro/college championship game, you probably won’t find many grunts, artillery, or cav guys there. The warfighters realize this and the fact that the average civilian equates being an infantryman as just as exposed to fire a loggy has to take a toll on the former.
Finally, it seems a shame that one of the weakest departments of the executive, at times, seems to be the VA. For all the success of the Montgomery GI Bill after WWII, you can’t ignore the history of poor service to veterans from the VA and the government. From failing to pay war bonuses in what seems like every conflict up to WWI, to the inefficient bureaucracy of the VA’s disability and treatment program that plagues us even today, I can’t understand why this hasn’t been fixed. I’m sure the VA is much better than it used to be in providing health care, it doesn’t surprise me at all that David was met with what seems to be unorganized and indifferent care. Sadly, I don’t think we can ever increase the quality of VA treatment across the board while civil service is viewed by many in this nation as a guaranteed pay check and benefits that comes with a minimal standard of effort and competency and a job from which it is near impossible to be fired from.
It pains me that I don’t have the answers that solve these problems. I applaud you for getting it out in a forum like this. I know the local soup kitchen here in Columbia is frequented by homeless vets. I’m planning to go down there with one of the groups at my law school to see if we can get some of them to put in VA Claims or at least seek out what services they do qualify for. Though I think we need to do more, at least we have a country that has something.

 

DESELBY

12:38 AM ET

July 29, 2010

Betrayal

One cause of severe PTSD is the betrayal of soldiers by their commanders.

Officers have done some bad things to troops who broke after tours in Iraq and Afghanistan and got too drunk or smoked some weed. Thousands of combat veterans have been discharged other than honorably for relatively minor misconduct, mostly self medication after the military didn't treat their PTSD.

I know a few soldiers who got "treated" this way - other than honorable discharges after they smoked pot after their 15 month tours in Iraq.

Senator Bond had a bill to review all of these discharges, I don't know what happened to it.

 

ANON

9:33 AM ET

July 29, 2010

@DESELBY

You may be thinking about HR 1701

http://www.govtrack.us/congress/bill.xpd?bill=h111-1701

 

ANON

10:08 AM ET

July 30, 2010

A little late...

but PTSD goes back as far as warfare itself. I had a chance to see this a few years ago. Riveting.

http://www.baltimoresun.com/topic/la-me-ajax-20100726,0,7082100.story

Combat veterans, and their loved ones, say the themes of Sophocles' 2,500-year-old play are painfully familiar. It was staged as part of the Pentagon-sponsored Theater of War project.

 

LIGHTNING6

2:15 PM ET

July 30, 2010

agreed

Combat is just another name for trauma. And humans have never been immune to trauma - we are emotional and social creatures - there is nothing about modern warfare that has changed the human condition.

Thank you for posting this.

Sincerely,
Blake Hall

 

SAINTSIMON

4:40 PM ET

August 7, 2010

How many suicides fray the

How many suicides fray the sympathies of the Taliban, of AQ? What havoc does PTSD wreak through their ranks? You have an agenda, Tom - every regular reader of this blog knows what it is. I have two close friends who are Marines, now discharged, guys who have given a lot and seen a lot. I went to see Restrepo with them the other day - I asked them "After everything you've been through, do you miss it?" Each, without much hesitation, said yes. Liberals can't understand something like that - it offends their sensibilities.

 

Thomas E. Ricks covered the U.S. military for the Washington Post from 2000 through 2008.

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