The Impact of Post Traumatic Stress on All Levels of Leadership

Having served in the Middle East for approximately 32 months, I often become overwhelmed by the thoughts and reminders of my time there. It is really tough to acknowledge such feelings to peers or superiors without concerns that they may see weakness in me as a leader, Soldier, and person. I had the toughest time dealing with these constant thoughts and reminders as I transitioned from my duties in a unit that frequently deployed, to my duties as a Brigade Command Sergeant Major of a Basic Combat Training unit at Fort Benning, Georgia. In my new position, I continued to embody the traits and characteristics that I thought had kept my Soldiers and me alive for 32 months in the Middle East and to incorporate them into my everyday work habits.

Becoming the 192nd Infantry Brigade Command Sergeant Major when I returned from Iraq in 2005 was a wonderful honor. For most of the first nine months after my return, my men did not seem to realize that their Brigade CSM was not doing well at all. I was able to perform my military duties on a daily basis without any negative thoughts whatsoever. However, in February of 2006, I had to attend a Soldier's memorial service. As I walked into the chapel, my body began to tremble, and my mind began flashing back to memories of the Soldiers I had lost during my last deployment with 2nd Squadron, 11th Armored Cavalry Regiment (ACR). The chaplain spoke and then the roll call was given. I felt my body quivering inside, my eyes began to water, and then tears rolled like a waterfall down my face.

I asked myself almost instantly, "How did I get like this? What was the root cause of these issues? What did I see that triggered these recurring memories?"

I had no control; as a warrior and a member of a team, I found that being reduced to this condition was tough to swallow.

After the roll call finished and we all stood up, I said to myself, "OK, the worst is over."

Then, without warning, the bugler began playing Taps, and that sound struck like a knife into my heart. I could feel my knees buckling, and then I couldn't feel my legs at all, so I grabbed onto the front bench. The Brigade Commander, Colonel Charles W. Durr, Jr., looked at me and immediately knew that this experience was having a negative effect on me. You know, it's really nice to have good leadership while you're serving your country—to have an inspired leader is almost the norm—but to have one who is also compassionate makes a big difference to a Soldier. The Commander reached out to me later, and we talked briefly about this service having been worse for me than any memorial I had attended in Iraq. Soon after the memorial service, I began to lose control of my eating habits, and nightmares came every night. I worked longer hours in order not to have any free time. The only problem is that one can work only so much! I struggled, wondering what had triggered these issues and whether or not my fellow Soldiers were having the same problems.

I was diagnosed in March of 2006 with Post Traumatic Stress (PTS), but like many leaders, I put off any treatment—I was too busy. Too busy almost cost me forever! Later when I talked with Yvonne Wilbanks, Fort Benning's Alcohol & Drug Control Officer, I learned that PTS needs to be treated early to try to avoid other serious problems such as depression and substance abuse. Her office, the Army Substance Abuse Program, had sponsored training on PTS in conjunction with National Depression Screening Day at my unit.

On May 5, 2006, while attending a course at Fort Jackson, everything came full circle when I found myself crying continuously for about an hour. I couldn't stop thinking about those Soldiers who had died in Iraq. Earlier that morning, I had awakened from one of the worst dreams I had ever had. It wasn't really a dream, though—I was there! I was experiencing the after-effects of losing two great company commanders and watching their bodies being placed into bags. I knew then that I should go for counseling.

Although I had not developed substance abuse issues, I did gain weight and was up to 260 pounds. In spite of the weight gain, I was remarkably fit and able to run better than most. However, I found myself not feeling very well, and I consulted a primary physician assistant who sent me to the hospital to have some lab work done. Early the next morning I received a phone call from the TMC (Troup Medical Clinic). The caller sounded a little anxious.

She said, "CSM, you need to come to the TMC right now."

I replied, "I am in a meeting."

She said, "CSM, don't make me come get you."

I went into the physician assistant's office, and he told me that my lab work showed signs of heart disease. He said that if I didn't do something about it soon, he couldn't predict a timeline for me. We talked about the findings and about my family history. My father and his brother had both passed away at the ages of 64 and 65 from heart disease, so my family history was not encouraging. After contemplating all this information, as well as learning of my booming blood pressure, I took a hard look in the mirror. I decided to receive counseling, via the telephone, from a combat stress doctor at Walter Reed Medical Center. I had been counseled by this same doctor in Iraq during my last deployment. I started dieting and working out harder and harder. The TMC folks continued to stay on top of my progress, monitoring my daily blood pressure checks and monthly lab work. During this period I learned that the root causes of all my issues were the anxiety and emotional instability that I had been dealing with since my extended stay in the Middle East.

Though we, as leaders, choose to fight most of our individual battles by ourselves, it's comforting to know we have excellent medical personnel who care about Soldiers of all ranks. We definitely don't appreciate them enough! Ms. Wilbanks told me that leaders can be helpful to their Soldiers by being aware of the symptoms of PTS and making it a priority to get training and assistance for each Soldier who needed help. I believe my personal experiences have made me more sensitive to helping my Soldiers. Over the years, I have at times made light of that fact, saying, "I thank God for the ACUs" which covered up all the additional pounds that I had gained because of my anxiety. Those uniforms had room for my growth, and although I am sure that others noticed my weight gain, they were kind about it.

My weight issue was corrected through continued dedication and with the help of the medical staff at TMC 5. I began working out twice a day, mostly running and going to the gym. Spending a lot of extra time working out made a really big difference for me. Not only did I gain a lot of energy, but also I truly believe that the extra effort to achieve fitness helped me control some of the mental challenges that I had to deal with when I returned. That first summer back home, after three years of deployment, was a tough one for me. For 30 months, the battle rhythm of combat had kept me focused and engaged. To say I had felt at home in Iraq would not have been far from the truth. It was hard to feel the same way when I first came back.

After six months of extensive working out, I had lost more than 40 pounds and could run like the wind again. As a result, physically, I felt and continue to feel terrific. Emotionally, I have recovered to a certain degree. However, I still have issues whenever someone mentions a Soldier's death. For example, who would have thought a Soldier could have a Post Traumatic Stress incident while running down the road in a garrison environment? I was running down Moye Road at about 5:45 AM when, all of a sudden, three loud bursts of gunfire rang out. My heart felt as if it had stopped on the first burst. Then there was a second burst and then the third. My eyes began to water—I knew instantly what the reason was for those three volleys. It was a firing squad from the 1st Battalion, 50th Infantry, rehearsing for a funeral support mission. I tried to continue running, but I was remembering that time and time again this had happened to me over the past four years.

Post Traumatic Stress, in my opinion, is not curable in my case and will remain a part of my life forever. I am dealing with it by trying to replace bad memories with the great memories of those fallen comrades whose efforts have protected our American way of life. We, as leaders, have not been trained to handle our reactions to losing our Soldiers or even losing our fellow leaders during combat. We continue to learn and grow through the struggles of our current conflict. It's an instinct to be a warrior. It's also an instinct to be saddened by the recurring memories of the loss of those great Americans. I am not able to develop an instinct to force these memories to disappear. Ms. Wilbanks emphasized that when these memories interfere with normal functioning or result in thoughts of suicide, we must get help immediately.

With that warning in mind, when I attended a 47th Infantry Regiment's reunion, I talked to some of the heroes who had fought in previous wars. I talked to them specifically about what I was feeling and going through on a daily basis.

The best words I heard were, "Never forget, but let it go." I would add, "Never forget, get help, and let it go."

Stigma—A Returning Soldier's Worst Enemy

STIGMA—A sign of social unacceptability: the shame or disgrace attached to something regarded as socially unacceptable (Encarta World English Dictionary).

What is this really saying? In my opinion, stigma is nothing more than fear of the unknown, as it relates to Post Traumatic Stress (PTS).

Leaders and family members are challenged because they don't know enough about PTS. They fear those who have it, they do not understand it, and they may place a stigma upon those who have it. Leaders may live in fear of developing it themselves. We who suffer from it believe we are closer to being normal and honest than those who say of their war experience, "It didn't affect me at all." As Soldiers, veterans and leaders, we are supposed to be strong, brave and true. Fear is something the enemy feels toward us. We run to the fight—not from it. But in reality, we do have fear. Fear of letting our team down. Fear of not measuring up. I remember asking the commander from my brigade in Iraq to allow us to remove our combat gear on the Forward Operating Base. When he refused, I explained to him my thoughts that the enemy was looking at us and saying, "We have them on the run; they're scared." About half way through the tour, we took off our gear, and the enemy realized we were no longer afraid of them. One day a month, they attacked us with mortars to see if we would go back into our shell. I believe this conduct made us stronger. Similarly, I think that those who have PTS will become stronger when society recognizes that they are normal and welcomes them to come out of the shadows.

As leaders, we have to demonstrate the art of leadership (the ability to influence Soldiers to accomplish a mission, no matter how dangerous). As I traveled across America and spoke to Soldiers, families, leaders, veterans and staff members of the Veterans Administration, I was asked the same question over and over again:

"How did you feel when you started openly talking about your struggles with Post Traumatic Stress? Were you afraid of what your fellow Command Sergeant Majors thought of you?"

The answer is "Yes." But over the last seven years, I've learned to control that fear. In 2005 and 2006 I kept those fears close to my chest. Only my therapist and a few close friends knew of my struggles. However, in April, 2007, I had to speak out. I had to get additional help after thoughts of suicide started flooding my mind. Initially, I felt anxiety, depression and extreme emotional stress after a magazine article I wrote about PTS was published in a military publication. Some days I would be resilient and accept the idea that tomorrow would be better. The friends that were true friends accepted me and helped me develop coping skills. However, there were others who couldn't or wouldn't acknowledge that I needed help. They shunned me. It's hard to accept being one person going into a war, and being a stranger to yourself coming out of that war. The sights, sounds, smells and feel of war change an individual. Those leaders who shunned me are now my friends. I don't have any hatred or any ill feelings toward them. PTS, with its stigma, and TBI (Traumatic Brain Injury) involve a learning curve. People must come to accept the fact that when Soldiers have survived very tough parts of life, they need time to adjust to normal conditions. We almost need to do as we did when we sent Soldiers to Germany. At that time, we created a Head Start program to teach them the basics of the German language to facilitate their adapting to the society they were visiting. Why don't we create a crash course on life after war? We could learn how to help a fellow warrior adapt to normal life again by recognizing signs and symptoms and learning a skill set to assist him in the adaptation process every day. We could teach him resilience.

Using Resilience and Support to Fight Suicide

I have gained strength through building resilience. However, in spite of great family and community support, I still face challenges every day. No other person can know exactly what I am thinking or how I may react to those thoughts. I must always be my own first line of defense, but it is important to have a good listener who understands my needs.

My 32-mile commute to work at Ft. Benning offers a lot of time for my mind to wander. One morning, after a tough night of really bad dreams, I was thinking about the loss of so many Soldiers who had served with me. I kept wondering why I had survived when so many others had not. I was trying to focus on the future and struggling to understand why I was having so much difficulty adjusting. The constant pain inside me seemed endless. It was the everyday anxiety that many warriors of past and present wars continue to struggle with, whether they admit it or not. When placed into uncomfortable situations, I frequently became nauseated and made numerous trips to the bathroom. I often thought about taking my own life. Just as I was thinking about how my life had changed since January of 2008 when Cathy and I married, the blue tooth phone in my truck rang.

I heard Cathy's voice saying, "Are you okay? You didn't look so good this morning." They were not the words one wants to hear from his wife.

Her next words were, "I love you. It'll be okay. We will handle it."

Those were comforting words coming from a very giving person. Cathy has blessed my life, reaching out to me and helping to lift me from the bottom of the barrel of my life's struggles. Before 2008, I had felt alone and helpless. I had gone through a divorce and battles with PTS and suicide. When I met Cathy, she embraced me for who I am, not for what I was suffering. I spent many months prior to our marriage trying to figure out why she loved me in spite of the fact that I had so much baggage and so little to offer her.

When changes occurred in my life, Cathy and I tried to handle them by dealing with one at a time, but the anxiety and depression continued. Although I was surrounded by a wonderful wife and a daughter who seemed to accept everything about me, I still wondered if my life would be another survivor story or the story of the last straw that broke the warrior's back. Seeing horrific injuries and death torments the soul, and there is always a battle after one has come close to taking his/her own life. I believe I am more vulnerable now than when I first considered it. My research shows that 30% of those who try to take their own lives eventually succeed. I don't want to be in that group. We American Soldiers, veterans, fathers, sons, and friends need to embrace those that want to support us. Had I not spoken out, I probably would be a statistic today. I could have been one of the many Soldiers who have taken their own lives. I am sure that coming out and speaking openly about my struggles with Post Traumatic Stress and suicidal thoughts saved my life.

Quite often these days, I attend funerals of Soldiers killed in combat or, sadly, killed by their own hands. When we lose a brave Soldier in combat, we honor his memory with flags and ceremonies. When we lose a Soldier to suicide, we ask why. Those who suffer with PTS know why. The haunting despair that never stops lurking around the dark corners of the mind finally pulled the trigger. Post Traumatic Stress distorts reality. It makes life cheap. It is a death trap unless you get help. Suicide in the military is on the increase. I believe that stigma is at the heart of that problem. We need to help others to understand our illness and remove its stigma, and we must be brave enough to ask for help.