Soldiering on with PTSD
It was late 2012 and I was commanding an infantry company in Kandahar. At night, when we came back from foot patrols, five of us would build a small fire in the corner of the outpost. We’d light scraps of wood inside half of a rusty metal drum and line rickety benches around the braids of flame. Sometimes we talked about missions, smoked cigars and laughed with each other to the point of tears. Other times we quietly listened to the crackle of the wood, each man consumed in his thoughts, hoping the fire would never go out. In those times, I thought of the men who weren’t there.
Following that deployment, I moved to Massachusetts to study at Fletcher and Harvard. Yet even as I formed friendships with classmates and deepened my grasp of international affairs, I continued to think of those men who hadn’t been able to join us around the fire. Of the 135 soldiers I’d led in more than 200 battles over the course of nine months, five had been killed and more than 20 wounded.
Having served in Afghanistan on four previous deployments, I had started this last one convinced that I was accustomed to the realities of war. I had witnessed casualties in the past, and had no illusions that we’d all be safe. However, the violence in 2012 was greater than any I had known before. One day, while I was leading a foot patrol, several IEDs detonated along a narrow path. Torn limbs, bloody faces and unspeakable guilt followed me out of that village. I carried all of it home.
My self-imposed guilt wore on me as I relived the most difficult parts of the operation over and over again in my mind. I began to question my actions and leadership in combat, and found myself constantly hypervigilant in nonthreatening environments. I struggled to focus on my studies and lost significant sleep in the process. I believed I was too resilient to ever need help, and suppressed the need to seek it, fearing I’d be perceived as weak. But at some level, I knew I wasn’t the same.
In 2014, when a doctor diagnosed me with post-traumatic stress disorder, it made sense. What’s more, it drove home the reality that while so much has been done to raise awareness about PTSD, the stigma attached to it is still immense. That stigma compels many thousands of active service members with the condition to try to hide it. And I was one of them. I had led men into tremendously difficult combat, and I assumed that leaders were somehow exempt from the impacts of war. I was wrong.
PTSD’s stigma grows partially out of well-intentioned but exaggerated portrayals of what the condition entails. In movies and on television, service members with PTSD are too often depicted as sketchy, drug-addicted characters prone to violence. These portrayals anchor society’s beliefs about what PTSD looks like, and tend to keep all of us, civilians and service members alike, afraid of it.
Several men I led and served with were reluctant to reveal their PTSD, thinking they might miss out on key promotions or be perceived as fragile or dangerous. The drive to avoid such perceptions is particularly pronounced within combat and special-operations units. Soldiers with PTSD often fear that they will be labeled as quitters who can’t hold their lives together.
Battling the Stigma
This remains the case even though military policy has focused extraordinary effort on removing the stigma around PTSD and has attempted to make it easier for service members to seek help. Veterans and journalists often lend context by speaking and writing extensively on the condition and its effects in the military.
What’s missing is the voice of active-duty members, especially those of us who lead at the small-unit level. It’s tough to find sharp young sergeants or captains who themselves are recovering from PTSD and who encourage their subordinates to get help while continuing service. And it’s the voice of such leaders that might make a big difference.
The reasons we remain quiet vary. Too often we think silence somehow aligns with being hard or professional. We may medicate our internal wounds with alcohol, painkillers or any other substance that provides escape. In combat, we may banish dark thoughts so we can take the battlefield with clear minds. Or we may tell ourselves that combat casualties, while tragic, are natural and may create only small fractures in soldiers’ resiliency over time. Accordingly, it can seem appropriate to suppress or ignore the effects of traumatic experiences.
Yet war can present horrors that cripple the mind. The way a young man screamed out in pain, the way a leg was torn away or how blood poured from a body may haunt even the toughest survivor. Such horrors require an in-depth healing process, and we service members who lead at the small-unit level have a unique responsibility to speak up about that.
We serve at the cutting edge of the military around the globe and have enormous leverage in the eyes of troops in the most challenging and complex assignments. Leaders in charge of small units are expected to represent the ideal mold of honor, courage and strength, and so our words carry exceptional weight.
PTSD is largely a solvable problem, and troops seeking rehabilitation are proving it—80 percent of those diagnosed with the condition remain on active duty after completing treatment. Many thousands of others deal with issues on their own. Rehabilitation comes in many forms, including counseling, connecting with veterans’ organizations and getting medical treatment. But it is never possible without a personal willingness to accept a measure of vulnerability in exchange for new strength.
We will rid the ranks of stigma only when we ignite change at the grassroots level, and frame our small-unit leaders’ experiences with PTSD treatment in a positive light. If we ignore this issue, we risk weakening a military population that is being asked to grapple with ever-increasing complexity around the world.
I plan to serve others in the Army for the rest of my career, and that’s why I’m talking about this. Keeping our military mentally fit is the most important thing we can do for our service members.
I still sit by the fire. It’s much warmer now.
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