In Iraq's War Zones, Therapists Take On Soldiers' Trauma
Thin Ranks Mean Repeat Tours For Troops Still Suffering From Last Round's Ordeal
Goal: 'Put a Lid' on Symptoms
By GREG JAFFE
Staff Reporter of THE WALL STREET JOURNAL
November 28, 2005; Page A1
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A combination of repeat deployments, tight troop levels and growing mental strain on soldiers has given a new prominence to Army mental-health workers. The Army has counselors from 10 combat stress detachments in Iraq, part of an unprecedented effort to help soldiers cope with psychological problems and finish their deployments. With the Army struggling to meet recruiting goals, it needs to keep as many soldiers in the fight as it can.
The Pentagon's focus on mental health reflects huge changes to both the Army and combat psychiatry since the Vietnam War. In Vietnam, commanders relied on a draft to provide them with an almost unlimited number of young, inexperienced soldiers. The vast majority of those troops served a required one-year tour of duty and never returned to combat. Today, the all-volunteer military is older, better trained and much tougher to replace. It is also being asked to do much more. Because today's Army is about half the size it was during Vietnam, soldiers are required to do repeat tours of duty. Even troops who struggle with traumas from a first tour will likely be asked to return to the combat zone for a second or even third round. Often their symptoms grow more acute with repeat exposure, say psychiatrists in Iraq.
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In Iraq, however, mental-health workers say it isn't that simple. Lt. Col. Dale Levandowski, the senior psychiatrist in Lt. Kimble's unit, says that it's impossible to provide troops the full treatment they need to recover as long as they remain in Iraq. A combat zone "is not the place to dig into everything and process every trauma," he says. Often the best he can do is give soldiers a few days rest and a chance to vent. He teaches them coping techniques. Sometimes he prescribes Ambien to help them sleep or Zoloft to ease their anxiety. The goal, he says, is to "put a lid" on the soldiers' symptoms so that they can function. Then he sends them back to the front lines to face additional violence that recent research suggests could make a full recovery even tougher.
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One of the biggest issues mental-health workers face in Iraq is post-traumatic stress disorder, which is triggered by such experiences as combat, rape, or seeing dead or dying people. The condition can be debilitating, causing people to suffer for years with nightmares, flashbacks, anger, depression and anxiety. Treating post-traumatic stress in the war zone is especially tricky, since soldiers are engulfed in trauma, to varying degrees, almost every day. As a result, Army psychiatrists have to make tough decisions about how much more trauma soldiers can take. "I do ache for these guys," says Col. Levandowski. "But if you send too many
home, the risk is that mental health will be seen as a ticket out of country."
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Write to Greg Jaffe at greg.jaffe@wsj.com
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