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Healing the Invisible Wounds of War

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"It's a good tool that provides a number of vignettes of servicemembers who talk about their experiences," Army Brig. Gen. Loree K. Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, said in an interview last month.

The concept runs counter to the stereotypical image of the stoic troop who fights not only through physical pain, but also psychological distress, she said.

Army Brig. Gen. Loree K. Sutton"Part of our effort really is aimed at transforming our culture -- to move from what has been a very illness- and medically focused culture -- and absolutely broadening it to where we're focused on resilience, on performance, on those things that individuals, families, leaders and communities can do that will both maintain their wellness [and performance]," she said.

You're not sick if you need a little [psychological] tune-up.

Some $300 million has been invested for research into psychological health and brain injuries. Funding is helping to treat a military engaged in Iraq and Afghanistan in counterinsurgency-type operations, which Sutton characterized as "one of the most psychologically corrosive environments known
to warfare."

"You're not sick if you need a little [psychological] tune-up," Sutton said. "You're experiencing normal responses to clearly what is beyond the pale of human experience. It is beyond what most folks could ever even imagine. And, of course, our troops are doing this repeatedly."

To prepare warfighters in the pre-deployment phase and further reduce the stigma, the Army has established "Battlemind" training. This regimen is designed to raise the level of importance associated with soldiers' mental fitness on par with
physical conditioning.

"Battlemind training [is] probably the only mental-health training that has actually been validated and shown that people who got it have less severe symptoms upon their redeployment," said Brig. Gen. (Dr.) Rhonda Cornum, the Army's assistant surgeon general for force projection.

Those who complete the Battlemind training also feel more comfortable seeking mental health treatment, Cornum said at a Pentagon discussion on troop care this month.

Speaking at the Association of the U.S. Army conference last month, Cornum said the high rate of post-traumatic stress disorder is one of the driving forces behind the creation of the wider-
ranging appraisal.

"Being 'Army Strong' is, in fact, being more than just physically fit. A lot of it's in your head," she said. Cornum added that instances of PTSD are about twice as high in people engaged in combat than those who deployed but were not involved in direct combat.

Cornum recommended that the Army evaluate comprehensive fitness as aggressively as it does physical fitness. Similar to the way the Army grades physical health along an axis, scores will be meted out for mental and emotional capacity.

Strong fitness in these latter realms is characterized as high levels of resilience, adaptability, self-confidence and agility. On the other hand, if soldiers exhibit stress, insecurity, immaturity or a lack of discipline, they might receive a poor score.

Soldiers who register a mid-level score may undergo education or training, while those with ratings just below average might receive some form of therapeutic regimen. The Army will step in when soldiers need direct intervention, Cornum said.

The general said the most vulnerable demographic is members of the junior enlisted ranks, who tend to be younger than their higher-ranking counterparts. But the proposal entails comprehensive fitness assessments for all force members, over their
entire careers.

Being 'Army Strong' is, in fact, being more than just physically fit. A lot of it's in your head.

At the senior enlisted level and within the officer corps, emphasis will be placed on training programs to help these personnel instruct and instill these values in their younger subordinates.

"This is going to be a culture change for the Army," Cornum said. "But I think it's really important, because these are life skills and capabilities that you can train."

(Gerry J. Gilmore of American Forces Press Service contributed to this report.)