P.T.S.D. Can Yield Positive, Yet Sometimes Deadly, Results

By JIM RENDON From http://6thfloor.blogs.nytimes.com/2012/03/22/p-t-s-d-can-yield-positive-yet-sometimes-deadly-results/

Just as my story about the Army’s program designed to help boost resilience in soldiers was approaching its final edit for The Times Magazine, news broke of the killing of 16 Afghan civilians by an American soldier. As details emerged, and Staff Sgt. Robert Bales was accused of committing this atrocity, I was stuck by the similarities between him and many of the soldiers I interviewed for this article.

Bales is a 38-year-old father of two who was on his fourth combat tour. He suffered multiple injuries, including mild traumatic brain injury and, possibly, according to his lawyer, P.T.S.D, yet he was sent back to combat. Soldiers going on their third and fourth deployments are not uncommon because these wars began a decade ago. Sgt. Jeffrey Beltran, who is featured in the story, was severely wounded in Iraq (he too suffered a mild, traumatic brain injury) and was on many medications when he was sent to Afghanistan. He was later diagnosed with P.T.S.D. Bales’s experience — the stresses, the multiple tours, the injuries — is not very different from that of so many men and women in uniform.

George Bonnano, a professor at Columbia University, whom I interviewed for the story, has found that soldiers are more resilient than the rest of the population — more of them recover from traumatic experiences without incident than in the general population. That may be because those who choose to join the military are more resilient to start with. Those who stay, like Beltran did, are most likely even more resilient. Yet, these men and women are not indestructible.

In the course of reporting this story I spoke with dozens of soldiers who served in combat zones, many of them multiple times. They all told me that no matter the number of tours, leaving for combat and returning home is always hard. In addition to the combat-zone stress, soldiers are also connected to home in ways they never were before: Skyping with spouses and children, for instance. For some, it is a source of strength, for others, a source of stress, for most it is likely both — a way to connect with loved ones, a reminder of what they are missing at home and a way for the daily stresses of bills, child care, the ups and downs of marriage — to seep into their challenging lives in a war zone.

And, when soldiers return home, their world is again turned upside down. Many soldiers who consider themselves healthy talked to me about struggles at home. Nearly everyone slept poorly. Some were unwilling to open up emotionally, even years later. During one conversation, several soldiers all laughed when they simultaneously referred to the massive, crowded aisles of Wal-Mart as Trauma-Mart.

It is not clear how to identify those who will be able to cope well with these stresses and those who will not. The Army’s Comprehensive Soldier Fitness Program, discussed in depth in the story, is an institutionwide effort to help soldiers handle these stresses better. The idea is to try improve everyone with the hope that those most susceptible to the stress will be a little less susceptible; those already somewhat resilient will be more so. The most seasoned soldiers I spoke with applaud the program’s goals. Many wished there had been something like it for them before they deployed three or four times. Instead they had to figure it out on their own.

Nothing excuses the cold-blooded slaughter of civilians that Bales is accused of. And we do not yet know what was going through his mind. The soldiers I met and hundreds of thousands of others, have served, been wounded and struggled with the aftermath of their experience, and all of them handle the stress one way or another. Most do the best they can on their own, riding out the bumps until they start to connect again here at home. Some develop P.T.S.D. and, as is discussed in the story, many soldiers feel that they change for the better as well, precisely because of the struggles they face.

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