Comprehensive Soldier Fitness program aims to equip troops mentally

Brig. Gen. Rhonda Cornum found out what combat stress was in the back of a pickup during the first Gulf War in 1991 when one of her Iraqi captors unzipped her flight suit and, as she lay there with two broken arms and an injured eye, sexually assaulted her.

The reed-thin Army physician, whose Black Hawk helicopter had been shot down, became a symbol of everything America was worried about in sending women to war. Her successful return home — sane and not that much the worse for her ordeal — became a powerful argument for the irrelevance of gender in conditions of indiscriminate violence.

To Cornum, it was also an example of how a strong constitution and positive thinking can help soldiers, male and female, through unthinkable ordeals.

“As I was crashing, I knew that my only two choices were either I was going to be dead or I was going to be a prisoner, so when I became a prisoner, my first thought was how grateful I was [that] I was a prisoner,” she said in an interview.

As the Army struggles to deal with an increase in suicides and combat-related stress stemming from 10 years of war in Afghanistan and Iraq, Cornum has been deployed to lead the military’s new mental fitness program. It is designed to prepare soldiers for the psychic trauma of war and its aftermath.

The $125-million Comprehensive Soldier Fitness program requires soldiers to undergo the kind of mental pre-deployment tests and training that they have always had to undergo physically. Already, more than 1.1 million have had the mental assessments.

“We send people to the range to learn marksmanship, and we first teach them how to sight the weapon, then how to hit stationary targets, then pop-up targets. You learn these kind of tactical things in a progressive, sequential, intelligent way, but prior to CSF, we didn’t really have a deliberate training program to build psychological competence and health,” Cornum said.

“We kind of assumed everybody would do well until they didn’t, and then we tried to treat it. That’s not the optimal approach.”

The program has won broad support from the American Psychological Assn., which devoted an entire issue of its journal to it in January. But a few independent psychologists have said the program amounts to a high-risk psychological experiment on soldiers who have no way to opt out. Further, they say, by encouraging psychological “resilience” in the face of danger, the program could actually propel troops into perilous situations.

“It is indisputably a research project of enormous size and scope, one in which a million soldiers are required to participate,” Roy Eidelson, past president of Psychologists for Social Responsibility, wrote in an article this year for Psychology Today.

“Master resilience trainers … will not encourage soldiers to empathize with the humanity of the adults and children whom they may have killed as collateral damage,” Eidelson wrote, “nor to use forms of restorative justice for apology and reconciliation that have a potential for deeper healing.”

Army leaders say most soldiers come home from war mentally stronger than when they left — the challenge is how to transmit those coping skills to the 20% who don’t. And even those troops who do well after combat may feel stressed after multiple deployments.

“Even though Desert Shield [the first Gulf War] was a pretty large-scale thing, it only lasted a few months. I think everybody recognized, in the military and out, that in a protracted war on terror and contingency operations, where we’re going to have not just one deployment but multiple in a career, that we really didn’t have a strategy of preparing people for those kinds of things,” Cornum said.

“Modern military service — in the ‘80s and ‘90s it was a pretty safe life. And then came 2001, and now it isn’t.”

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Army officials say the Army’s ability to continue operating in Afghanistan depends on the resilience program’s success.

“The suicide rate among our soldiers is at an all-time high. The number of soldiers suffering from post-traumatic stress is also high. And the stress of long separations due to combat is felt by our family members too,” Gen. George W. Casey Jr., the Army’s chief of staff, wrote in an article about the program this year. “As such, we are starting not with a blank slate but rather with the challenge of having the preponderance of our force influenced in some way — both positively and negatively — by the effects of sustained, protracted conflict.”

Where traditional military mental health programs have tended to target soldiers with known mental health or behavior problems, Comprehensive Soldier Fitness aims to take in everyone, teaching positive psychological skill-building in place of warning soldiers about what not to do.

“We don’t specifically mention suicide,” Cornum said. “We figure they’re getting bombarded with suicide messaging. We don’t mention drugs or alcohol. If you build psychological assets, people are less likely to use those maladaptive ones.”

The program was developed through the University of Pennsylvania’s Positive Psychology Center and its director, Martin E.P. Seligman, who already had done work using positive thinking to combat depression among students. It zeros in on five aspects of troops’ psychological health: physical, emotional, social, family and — controversially for some who have questioned the Army’s right to probe there — spiritual.

Troops undergo assessments in all five, beginning with a general mental health assessment. For any issues identified in the initial assessment, soldiers have access to Web-based training to help them work on those skills. “Master” trainers are given a 10-day course in how to hold talk sessions with their own troops back at the garrisons, building stress-fighting skills for soldiers and their families.

Cornum, who was one of three survivors of the Black Hawk crash taken prisoner, suffered broken arms and gunshot wounds. She was held captive for more than a week afterward.

She co-wrote with Peter Copeland an account of her experiences, “She Went to War,” in which she related how she dealt with the aftermath of the crash — with the rough groping in the back of the truck and the painful wait for release and interrogations that followed it.

“Ma’am,” Dunlap [one of her fellow captives] said quietly, ‘you’re really tough.”

“What’d you think, I’d cry or something?” I asked with a laugh.

“Yeah, I thought you would.”

“That’s okay, Troy,” I said after a while. “I thought you’d cry, too.”

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Since her first war, Cornum has faced other stresses: She has had breast cancer, been divorced, seen her second husband through two bouts of cancer and overseen medical troops in Afghanistan.

Now Cornum, who holds a medical degree as well as a doctorate in nutrition and biochemistry, makes regular visits to CSF training sessions at bases across the country and relates how she has put her coping skills to work.

“I’ve personally experienced individually how valuable it can be when you go through some of these adverse events,” she said. “I tell people I was very fortunate that I already had all those skills that would be helpful, really.”

The most important of them she learned as a prisoner, she said, “is Put It in Perspective: PIP” — understanding that although a situation might be bad, it could be worse.

But she also learned the importance of problem-solving, goal-setting and energy management.

So far, 6,700 soldiers have learned these skills as well. Having been certified as master resilience trainers, each of them is now training 50 to 100 soldiers back on base. Cornum said she had heard mainly positive responses from officers whose troops are enrolled.

“I talked to a colonel the other day. He implemented this,” she said. “He’s enthusiastic. He said, ‘You know, we used to do PT [physical training] 10 times a week. But I recognized I wasn’t losing soldiers because they couldn’t run. I was losing them for a whole lot of these other issues.’ ”

kim.murphy@latimes.com