Army Program Aims to Build Troops' Mental Resilience to Stress

JUDY WOODRUFF: Even as U.S. troops leave Iraq this month and, in three years, will depart Afghanistan, the psychological wounds of war will last for some time.

The NewsHour's health correspondent, Betty Ann Bowser, reports on a new Army program to help families and soldiers cope and the questions surrounding it.

BETTY ANN BOWSER: Here at Fort Bragg, N.C., the Army has always trained its soldiers to hit the bulls eye. And it's always taught the importance of staying fit. Now the Army is trying to teach its soldiers new skills to fight a war in unchartered territory in the human mind.

STAFF SGT. GABRIEL PRICE, U.S. Army: Everything begins with a thought. Everybody say that with me. Everything begins with a thought.

CLASS: Everything begins with a thought.

BETTY ANN BOWSER: Staff Sgt. Gabriel Price is a trainer in the largest psychological program in the Army's history. Called Comprehensive Soldier Fitness, it's being given to virtually all 1.1 million people in uniform.

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STAFF SGT. GABRIEL PRICE: There are some emotions out there that we don't handle so well.

BETTY ANN BOWSER: The long years of fighting in Iraq and Afghanistan have produced alarming increases in post-traumatic stress disorder, known as PTSD, depression and suicide.

So the Army is betting 140 million taxpayers' dollars that it can do something about those problems by changing the way soldiers think about bad experiences. But, officially, leaders say there's another reason.

Brigadier Gen. Rhonda Cornum is the senior commanding officer of Comprehensive Soldier Fitness.

BRIG. GEN. RHONDA CORNUM, Comprehensive Soldier Fitness: The real goal of this program is to give everybody in the Army certainly, and to include families and civilians, the opportunity to become as psychologically strong as they can.

KAREN REIVICH, Comprehensive Soldier Fitness: All day, we're talking about relationships, all day.

BETTY ANN BOWSER: The Army approach features ten days of intensive training in Philadelphia which emphasizes communication skills.

KAREN REIVICH: What are some messages that it sends when you are communicating aggressively to, you know, your family members, to your colleagues, to your troops?

BETTY ANN BOWSER: And they teach how to have more control.

KAREN REIVICH: You can be emotional when you are talking assertively, but you are composed. You are expressing your emotion. You are in control of the emotion you want to express.

BETTY ANN BOWSER: The trainers then go back and train the troops.

KAREN REIVICH: But if you're not feeding that relationship enough of joy multiplier, we're going to start to see damage.

BETTY ANN BOWSER: Psychologist Karen Reivich is the lead trainer.

What is the connection between all of this and producing more resilient soldiers, soldiers that are less likely to develop PTSD, are less likely to be depressed and less likely to commit suicide?

KAREN REIVICH: We teach these soldiers how, even when they are stressed, how they can keep their thinking in line, in check, so that they stay positive and composed and ready to tackle whatever the task is at hand.

BETTY ANN BOWSER: The psychological training was developed by psychologist Martin Seligman at the University of Pennsylvania. The Army gave his school a $34 million no-bid contract to develop and run the program.

Seligman is known as the father of positive psychology, which says that people can lead happier lives by learning how to better process negative thoughts. His theories are the basis of the Army program.

MARTIN SELIGMAN, University of Pennsylvania: What psychology and medicine and psychiatry have been about has been taking people after they have suffered bad events and trying to undo illness.

This is an attempt to turn medicine on its head, to turn psychology on its head, and say, let's arm people who are going to be put in harm's way beforehand, and see if that doesn't have a noticeable effect on saving lives, on lowering depression, on lowering anxiety.

BETTY ANN BOWSER: Seventeen research studies have shown children and adolescents improve when the principles of positive psychology are applied. And Seligman sees no reason why that won't also work in the Army.

MARTIN SELIGMAN: It's a training program based on the best evidence that science has about the prevention of anxiety and depression. So it seems to me quite a reasonable thing for the Army to be doing. If I had to look around the entire literature on anxiety and depression, and the prevention of it, this is the best documented hypothesis.

BETTY ANN BOWSER: But critics complain that hypothesis was never tested in a military setting before the program was rolled out. Is there any science-based research the Army can point to that shows that this will work on troops?

BRYANT WELCH: No, there's not.

BETTY ANN BOWSER: Bryant Welch is a San Francisco psychotherapist who's treated hundreds of trauma survivors. He says the studies of Seligman's work aren't enough to justify the Army's program.

BRYANT WELCH: They had schoolchildren, each night, write down three positive things about themselves. And then they noticed in a follow-up study that those children felt better about themselves.

But to go from that to saying that we can have a soldier in a foxhole who says positive things about himself and follows the precepts of this program, is going to watch his buddy blown to smithereens and spend four tours of duty in Iraq and Afghanistan and come out feeling better about himself, there is a shallowness to the assessment that, from my vantage point, I find abhorrent.

BETTY ANN BOWSER: Dr. Bessel van der Kolk agrees. He's one of the country's leading experts on trauma and teaches at the Boston University School of Medicine.

DR. BESSEL VAN DER KOLK, Boston University School of Medicine: It doesn't make sense from a neuroscience point of view, because -- and what all of our research shows is that trauma affects cognition. And the very piece that you need to think clearly and to be optimistic gets severely impacted by being traumatized. So, traumatized people cannot think straight because their brains are sort of locked in horror and terror.

BETTY ANN BOWSER: And van der Kolk says there are times when happy thoughts don't help people recover from trauma.

DR. BESSEL VAN DER KOLK: There's times to not feel cheerful. There's a time to feel a deep sense of guilt, of regret, of sorrow, of terror, because we have all of these emotions because we need all of them. And we should not prefer one over the other. And the treatment of traumatic stress consists of people tolerating every single emotion, including the bad ones.

BETTY ANN BOWSER: Master Sgt. Jennifer Laredo knows a thing or two about keeping thinking in line. Two years ago, while on a mission in Iraq, her husband, Eddie, stepped on a bomb and was killed. They were newlyweds. Today, she's raising their 4-year-old son and a teenage daughter from her previous marriage, alone.

MASTER SGT. JENNIFER LAREDO, U.S. Army: We fell in love and got married and just started a life together.

BETTY ANN BOWSER: In her home in suburban Fayetteville, N.C., Laredo keeps vigil over her husband's memory in a small room adjacent to the master bedroom.

MASTER SGT. JENNIFER LAREDO: My husband was buried at Arlington.

BETTY ANN BOWSER: After the tragedy, Laredo went through Comprehensive Soldier Fitness training. And, today, she believes it has made her more resilient.

Of all these sets of skills that you learned, what was the most useful after Eddie died?

MASTER SGT. JENNIFER LAREDO: Hunting the good stuff and recognizing and identifying positive things that happen every single day, because, every day, there's something positive that happens, and then taking that and figuring out, is there a way that I can ensure that that happens tomorrow and next week and next month? Resilience training is really just teaching people how to bounce back from adversity.

BETTY ANN BOWSER: Gen. Cornum agrees.

BRIG. GEN. RHONDA CORNUM: You can train people to put things in perspective and to decrease the amount of rumination that they do. Whether those are skills or -- we call them skills. I think those are skills. I think they're learnable and I think they're teachable.

If you see some horrific thing, you are very likely to be angry and you are very likely to be grieving if it was your friends or something. I think that what we do teach is that don't take responsibility upon yourself to feel guilt, because you are not responsible for those horrific things happening.

BETTY ANN BOWSER: Recently, the Army released an evaluation of the program, which said, in part, "There is now sound scientific evidence that Comprehensive Soldier Fitness improves the resilience and psychological health of soldiers."

But there is disagreement over that statement in psychiatric circles from doctors and Ph.D.s who say the evaluation is flawed and doesn't prove anything. Meanwhile, the Air Force is in the process of implementing its own version of the program.

JUDY WOODRUFF: Psychotherapist Bryant Welch and officials from the Army will answer your questions about the Comprehensive Soldier Fitness program online. Submit your questions to our website at NewsHour.PBS.org.

Source: http://feeds.pbs.org/~r/pbs/newshour-headlines/~3/UeSpG34jpxE/ptsd_12-14.html

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