Marines Take Up Fight on Postwar Stress

If there is an enduring cliche about war veterans, it’s this: Real men don’t talk about what they did and what they saw in combat.

But now the Marine Corps, in an effort to reduce post-traumatic stress disorder and other problems among troops returning from Iraq, has launched a campaign to encourage, even compel, Marines and sailors to talk about their experiences and their feelings.

In talking to troops, Navy Cmdr. Mark Smith, a Protestant chaplain, has a phrase to summarize the need to talk about bad memories before they become nightmares that hinder their ability to function: “You need to take out the garbage before it lowers the property values.”

Marines from the 1st Marine Expeditionary Force, now coming home after a seven-month deployment in Iraq, are being given health exams to detect early signs of post-traumatic stress disorder, among them, memory loss, intolerance, anger, sleep problems and “hyper-vigilance.”

Every Marine and sailor is also required to see the chaplain. The meetings can take five minutes, an hour or more, depending on how much the person wants to say, said Navy Cmdr. Bill Devine, head chaplain of the 1st Marine Division, who was with Marines during fighting in Fallouja and Ramadi.

Individual and group counseling are offered, along with marital counseling. Follow-up calls are made to all sailors and Marines after 30, 60 and 90 days.

Marines, at all levels, are under orders to abandon the macho culture of stoicism and overcome the stigma that surrounds seeking psychological help.

“I made it a point to say, ‘You’re not weak or anything less than a Marine if you ask for help,’ ” said Staff Sgt. Patrick Coleman, a platoon sergeant.

Before leaving Iraq, Marines must attend “warrior transition” briefings that explain the signs of post-traumatic stress disorder. They are also informed of the services that are available to all troops. Similar sessions are held once the Marines return to Camp Pendleton.

Leading by example, high-ranking officers are acknowledging that they’ve had problems adjusting after being in a war zone. Col. Darcy Kauer, commander of the headquarters group of the 1st Marine Expeditionary Force, told several dozen Marines at a briefing at Camp Pendleton this week that he was irritable and short-tempered when he returned from the 1991 Persian Gulf War.

“I’ve seen people come back -- even general officers -- with that 1,000-yard stare, emotionally spent,” Kauer said. “We can be psychologically, emotionally, spiritually injured.”

Marines at this sprawling base are being shown a welcome-home video in which Lt. Gen. Wallace Gregson, commander of Marine Forces Pacific, tells them to be on the lookout for signs of depression and stress among their buddies.

“It’s a harsh reality that some of you will commit suicide,” Gregson says on the video.

A Department of Veterans Affairs study published this week in the New England Journal of Medicine found 17% of 3,671 soldiers and Marines who saw combat in Iraq or Afghanistan reported early symptoms of depression, anxiety or post-traumatic stress disorder.

Camp Pendleton officials dispute such findings and note that they have seen no increase in alcohol abuse or domestic abuse, often signs of post-traumatic stress. Yet they concede that it could take weeks or months before stress factors kick in.

Chaplain Smith said that even troops who did not see a shot fired in anger can be injured psychologically as they learn of friends being killed and try to cope with the knowledge that even the safest of bases can be hit by mortar and rocket attacks.

At one base in Iraq, a Navy doctor was killed by a mortar round as he walked outside a tent to call his wife on a satellite phone. At another base, a Marine officer was killed by shrapnel that ripped through the portable toilet he was using.

Marines who have returned home can be affected by news accounts from Iraq.

“It’s one of the problems you have when you get back: You’re watching it and feel helpless to do anything about it,” said Brig. Gen. Joseph Dunford, assistant commander of the 1st Marine Division, who spent 22 months in Iraq.

Before Marines deployed for Iraq, training exercises prepared them for the “fear, uncertainty and chaos” they would experience, officials said.

And in Iraq, commanders tried to encourage troops not to bottle up their emotions.

Lt. Col. Paul Kennedy, commander of the 2nd Battalion, 4th Regiment, which suffered 35 dead and 180 wounded, had the television removed from the mess hall at the Ramadi base to force troops to talk to each other during meals.

At this week’s briefing, Smith advised Marines not to be afraid to break the stereotype that only bores tell war stories. Talk, Smith said, talk to your buddies, your chaplain and the health professionals on base.

“It makes you one of those boring old veterans, but it keeps you well,” Smith said.