War Trauma Is an Admission of Weakness in 'Macho' Army Culture

The seven qualities of leadership itemized in Army Field Manual (FM) 22-100 are loyalty, duty, respect, selfless service, honor, integrity and personal courage. Nowhere in that list is there any reference to heartlessness, lack of compassion and a cavalier disregard for the wellbeing of one's troops. And there is certainly no reference to posturing, denial or dissembling. Leading by example trumps mindless stoicism every time.

Back in 1974, when Betty Ford was diagnosed with breast cancer, mastectomy was still considered a taboo topic, too shameful and frightening to be openly discussed. "Too many women are so afraid of breast cancer," she told a gathering of the American Cancer Society, "that they endanger their lives. These fears of being 'less' of a woman are very real, and it is very important to talk about the emotional side effects honestly. They must come out into the open."

Ford's courageous decision to use her position as First Lady to set a visible example for other women made a significant impact on public attitudes. According to the New York Times, "Within weeks, thousands of women who had been reluctant to examine their breasts inundated cancer screening centers. One of those following Mrs. Ford's example was Happy Rockefeller, the wife of the Vice President, Nelson A. Rockefeller. She, too, had breast cancer and underwent a mastectomy. Mrs. Rockefeller and many others said Mrs. Ford's example gave them the courage to discuss their experiences openly."

Researchers have since dubbed that phenomenon the "Katie Couric Effect" in honor of the co-anchor of NBC's "Today Show" who, in March 2000, underwent a colonoscopy on live TV. Couric, who lost her husband to colorectal cancer in 1998, decided to undergo the procedure on-air to "further the science being done on all aspects of colon cancer and increas(e) awareness about the critical role screening plays in combating the nation's number two cancer killer." According to Mark Fendrick, one of a team of University of Michigan doctors who studied the public response to the Couric demonstration, in the days and months following, the number of Americans who signed up for the exam rose by more than 20 percent. "This test," said Fredrick, "which requires healthy people to undergo an invasive, uncomfortable and often embarrassing exam, especially needed a celebrity advocate to reduce the stigma and fear, and thereby increase participation."

Interesting. A celebrity advocate to reduce stigma and fear.

In our military today, the stigma and fear that attach to post-traumatic stress injuries is a contributing factor to the current epidemic of suicides among American soldiers and veterans, 120 a week according to the recent study by CBS news. The stigma attaches to any admission of weakness, especially weakness of mind. The fear is of being shunned, shamed, punished or encumbered by a health record that might compromise future employment options. That stigma and fear might be profoundly challenged by an officer willing to go public with his -- and I use the male pronoun intentionally -- post-traumatic stress.

The need for service members to forego notions of manliness intrinsic to traditional military culture, to "come out of the closet" as it were, was raised poignantly by Mike Bowman, the father of Tim Bowman, when he testified before the House Committee on Veterans' Affairs in December. Tim, a Specialist in the Illinois National Guard, suffered from post-traumatic stress and took his own life after returning from Iraq.

Bowman made the point that, like most of the rest of the guys in his unit, Tim refused to go to the VA for help when his symptoms became invasive. Instead, they seek "counseling of some form or another -- privately - away from the military, away from the V.A., some as far as 100 miles away from home, to make sure that that information does not get back to their unit." In his statement, Bowman emphasized the courage and clarity evidenced by a soldier admitting a psychic injury. Instead of punishing or decrying such a soldier, Bowman insisted, "Grab that soldier and thank him for saying, 'I'm not OK,' and promote him. A soldier that admits a mental injury should be the first guy you want to have in your unit because he may be the only one that really has a grasp on reality."