Combat stress appears in many forms, and its aftereffects often are concealed by veterans who cling to "the stoic ideal."
Along-held focus on combat leadership, particularly at the small-unit level, lies behind the Marine Corps’ exemplary record of success in battle. The consistently high quality of leadership under fire demonstrated through the years stems directly from the Corps’ unique policy of providing a common foundation of fighting skills for every Marine, irrespective of occupational specialty. One aspect of this foundation is preparing leaders to deal, on a personal level, with the inevitable psychological and emotional trauma of combat. This aspect of combat preparation, for the most part, has been left to the individual’s discretion, as part of his personal reading program. Accumulated experience and recent insights into the mechanics of combat trauma and stress prevention, however, may provide the foundation for treating this highly sensitive issue explicitly in Marine Corps doctrine and training.
Dr. Clete DiGiovanni, staff psychiatrist for Officer Candidate School (OCS) and The Basic School (TBS), recognized this flaw in Marine Corps officer basic training several years ago and developed a lecture for lieutenants attending the Infantry Officer Course that addresses the human factors of combat. This lecture has provided a sound introduction to some of the mechanics of combat trauma to infantry graduates of TBS since 1990, but its overall impact suffers from its narrowly selected audience and thereby underscores the fundamental issue: Is there a need for a controlled program of combat stress control instruction for all Marines, regardless of their military occupational specialties?
Psychological injuries are not limited to the infantry combat arm. For example, in the Pacific Theater in World War II, the overall ratio of neuropsychiatric casualties to combat Wounded evacuees was 1:1. Significantly, most of these casualties were not from combat Units but were Combat Service Support (CSS) Personnel from rear areas. By 1970-71 during the Vietnam War, neuropsychiatric casualties became epidemic, accounting for more than 60% of all medical evacuees from the theater. During the 1982 Lebanon Crisis, one Israeli armor unit reported one case of battle fatigue for every one wounded in a desperate night action in which 45 CSS personnel (i.e., a combat engineer battalion) became stress casualties when they were bombed accidentally an Israeli fighter-bomber.
A growing body of contemporary literature offers personal insights into the reality of these statistics. We are only beginning to discover the existence of a “silent majority” of combat veterans who secretly have endured their own personal demons for the majority of their adult lives. In Achilles in Vietnam, Jonathan Shay compares the effects of combat on Homer’s Achilles as recorded in The Iliad with the effects of combat he has observed on many Vietnam veterans. In Caged Dragons, former Marine corporal Robert Haney describes the fire- breathing memories that came home with all who survived—and subsequently stoically suppressed the largely unimaginable experiences of a prisoner-of-war of the Japanese. Corporal Haney relived his experience every day and night for more than forty years, but he was unable to openly confront his personal dragons until he forced himself to unlock them from the prison of his deepest memories. Even then, despite the fact that he was a highly successful author of leading technical publications for the U.S. space industry, he could not write his memories down but had to dictate them into a recording machine. Even today, in spite of recording his terrible experiences, he bears his cross alone, unable to bring himself to discuss them with any person, not even a member of his own family.
Historical biographer and former Marine sergeant William Manchester delayed more than thirty years before confronting his own dragons in Goodbye Darkness. Likewise, Professor Eugene Sledge, former Marine mortarman, waited before summoning the courage to describe the naked terror of every man who participated in the conquest of Pelilieu. Most recently, General Norman Schwarzkopf revealed in a detailed account to broadcast journalist Dan Rather how he was unable to put the Vietnam War behind him until he returned several times to the scene of his private hell and confronted his past. General Schwarzkopf postulates that every Vietnam veteran must eventually find his own personal solution for ending that seemingly endless conflict.
Society’s lack of awareness of the immense personal toll associated with combat trauma is nurtured and sustained by the fact that most combat veterans deliberately hide their combat stress symptoms for personal reasons—the stoic ideal. The unfortunate side effect is that society at large simply does not understand the magnitude of the problem. Dr. Jonathan Shay suggests that the stoic ideal of suffering in silence is a complex ideal. One aspect of the ideal reflects the truth that civilians do not want to hear, and probably cannot hear, the truth about war without being spiritually injured by it—silence protects loved ones. Stoic silence also often reflects the ideal of patriotic loyalty. Many in the World War II generation find it extremely hard to see anything honorable or patriotic in those Vietnam veterans who publicly describe what they had witnessed and what they had done, which had wrecked them personally. Their “public narratives” were “political,” which to many World War II veterans seemed unpatriotic, and in the case of officers, went very much against the grain of necessarily remaining non-political. Another aspect of stoic silence is simply the ideal, standing on its own. of fortitude and avoidance of the vice of self-indulgence. Healing from the spiritual and psychological wounds of war happens only in community.
As we become increasingly exposed to the knowledge that combat stress is an integral and preventable aspect of combat, we must ask the question: “What are we doing to prevent it?” The U.S. Army initiated a deliberate attempt to prepare their combat leaders for controlling combat stress. On 29 September 1994, the Secretary of the Army published FM 22-51, Leaders’ Manual for Combat Stress Control, to ensure that all senior noncommissioned officers and company-grade officers know what to do about battle fatigue—how to identify it, treat it, and prevent it.
While FM 22-51 places primary emphasis on combat stress control, experience during recent peacetime catastrophic events clearly has demonstrated the value of crisis stress control for servicemen, their families, and civilians caught in the turmoil of peacetime operations. Catastrophic peacetime events such as the terrorist-related in-flight bombing and crash of an airliner at Gander, Newfoundland, while returning one-third of an Army battalion from the Sinai peacekeeping mission; the car bombings of the Marine barracks and American Embassy in Beirut; the “accidental” Iraqi missile attack on the USS Stark (FFG-31); the downing of an Iranian airliner by the USS Vincennes (CG- 49); the gun turret explosion on board the USS Iowa (BB-61); disaster relief operations following Hurricane Andrew; the federal office building bombing in Oklahoma City' and Operation Restore Hope in Somalia are prime examples of recent events that have required the immediate assistance of Army and Navy Stress Control Teams. Thus, stress control is becoming a significant factor for military personnel engaged in operational environments other than direct combat.
If the Marine Corps deploys ground and air forces to Bosnia, commanders at every level need to be aware that this pending commitment may well be one of the most severe psychological stress tests that Marines ever have encountered. If there is the slightest doubt in anyone’s mind of the horrors that exist there, listen closely to U.N. Peacekeepers who have walked the ground. This situation calls for unprecedented, specialized psychological preparation.
Some U.S. veterans have survived multiple combat tours without apparent physical, mental, or emotional harm—but many more than previously imagined have not. Those who struggle daily to cope with post-combat psychological trauma often are scorned or ignored by fellow veterans and a public that, for the most part, regards professional soldiers as expendable commodities. This apparent dichotomy only serves to highlight the issues. What are the psychological dynamics of combat stress with which every combat participant must deal? How are some combat veterans apparently able to cope and others not? Is there anything that can be done to prepare warriors psychologically for the mental, emotional, and spiritual shock of intense combat?
Until the Marine Corps has time to evaluate FM 22-51 and prepare standard formal training syllabi for senior noncommissioned officers and company-grade officers, one approach to this type of combat preparation could be a formal seminar inserted in The Basic School and Staff NCO Academy’s curricula. The seminar would serve the immediate purpose of raising the level of awareness of the vital necessity for combat stress control at the company-grade-officer and senior-NCO levels. Addressing the issue of combat trauma at TBS and the Staff NCO Academy makes sense from several perspectives. First, combat trauma training at these schools contributes to providing the common foundation of combat skills alluded to in the opening paragraphs of this discussion and broadens the narrow focus of current efforts. Second, the one essential thing missing from the Vietnam veteran’s stories in Dr. Shay’s book seems to be small-unit leadership. Second lieutenants and staff NCOs earn their pay according to the extent that they provide effective small unit leadership. Providing them with preventive combat trauma training is as fundamental to their leadership training as the skills associated with land navigation. Fire-support coordination, machine-gun employment, and all of the other basic fighting skills necessary to lead Marines during military operations.
One approach for this training could be a two-day seminar built around properly vetted, volunteer, combat veterans, who have been prepared by a reading and supervised discussion of FM 22-15 and selected excerpts from an appropriate reading list. Combat veteran seminar leaders can provide novice leaders with direct access to authentic experience. If properly constituted, the seminar would serve as a matchless learning experience for future leaders.
The Marine Corps must consider the efficacy of incorporating the training principles set forth in FM 22-51 in Marine Corps-wide training curricula. The principles of preventing combat trauma must make their way into training for all Marines as soon as possible. We owe this effort to those who struggle daily with the painful legacy of combat trauma; we owe it to those who prepare today to go in harm’s way; and we owe it to the families who await the return of these future heroes.
Colonel Ogden, a former artillery officer and Mr. Wehrle, a former Marine infantry officer, both are graduates of the U.S. Naval Academy and are a senior systems engineer and a senior systems analyst, respectively, with TRW.
Editor’s Note: An earlier version of this article appeared in the April 1996 Marine Corps Gazette.