Ending the Stigma: PTSD, TBI and Moral Injury in Senior Leaders

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Yesterday I wrote about the death of my former Commodore at EOD Group Two, Captain Thomas Sitsch who committed suicide on Monday outside a New Hampshire Hospital. Captain Sitsch was another casualty of the longest wars this nation has engaged.

Many senior leaders in the military, officers and senior enlisted of every service have frequently deployed to Iraq, Afghanistan as well as other locations in the war on terror. Since the war has been going over 12 years many have spent over half of their careers preparing for, engaging in, or recovering from wartime deployments. Many have suffered physical injuries as well as the unseen injuries of war, PTSD, Traumatic Brain Injury and Moral Injury. Unfortunately they are often the last people to seek help.

In the past few years I have personally known or know of a number of senior officers and senior enlisted personnel who have committed or attempted suicide or had their careers destroyed because of their actions. Some like Captain Sitsch were diagnosed with PTSD, others displayed some or all of the indicators but either refused help or put getting help aside in order to “stay in the fight.”

In the past couple of years the Commanding Officer of a deployed SEAL Team committed suicide in Afghanistan, two Marine Expeditionary Unit commanding officers were relieved after incidents that probably have their genus in PTSD, or Moral Injury. I would almost bet that some of the issues that some of our senior leaders have been relieved of their duties for are also the result of untreated PTSD, TBI, Combat Stress Injury or Moral Injury.

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Retired Canadian General Romeo Dallaire still suffers from PTSD following his command of the UN Rwanda force in the middle of that country’s genocide. He attempted suicide in 2000 and still suffers. Last month he was involved in a car accident on his way to work in the Canadian Senate when he fell asleep at the wheel of his car. He had not slept the previous night due to reliving the horrors of that experience. As someone who still suffers chronic insomnia related to my PTSD I understand how this can happen.

The PTSD of T. E. Lawrence’s experience of war in the Middle East in the First World War shows in the pages of his classic Seven Pillars of Wisdom and various letters. Lawrence, who could have risen to high rank in the military or the foreign service basically went underground under an assumed name to serve in the ranks of the Royal Air Force in the 1920s. He wrote to Eric Kennington in 1935 not long before his death in a motorcycle accident:

“You wonder what I am doing? Well, so do I, in truth. Days seem to dawn, suns to shine, evenings to follow, and then I sleep. What I have done, what I am doing, what I am going to do, puzzle and bewilder me. Have you ever been a leaf and fallen from your tree in autumn and been really puzzled about it? That’s the feeling.”  

That is a part of our military culture. Leaders are under a great deal of pressure to accomplish often impossible missions and to take care of their troops. Many have been exposed to repeated combat trauma and had to bury more than one of their troops, often after the person commits suicide. Many anguish over the deaths, blame themselves and heap guilt on top of grief on top of traumatic or moral injury.

As I said many do not seek help due to an overwhelming cultural stigma against getting help, or “going to the wizard.” Likewise they know that that the reality is that if they seek help them may never command or be assigned to sensitive career enhancing billets again. As one senior leader told me “its hard when they say if you have issues and they are known that you can still have a successful career, but you will never be promoted or selected to a critical position, again.” 

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A few senior leaders have admitted to suffering from the symptoms of Combat Stress Injury and sought treatment. The most senior was General Carter Ham who began to suffer symptoms following his deployment to Mosul Iraq in 2004. Major General Gary Patton has also sought help for PTSD. Lieutenant General Peter Chiarelli, now retired has taken up the cause to reduce the stigma seeking to have PTSD renamed Post Traumatic Stress Injury instead of “disorder” because it is an injury.

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I wish I had an answer. For me it took a complete crash to get help as well as the assistance of two fine EOD officers, Admiral Frank Morneau and Captain Sitsch. Even with that initial assistance I still feel a certain stigma. My experience is that senior leaders who admit to this and seek treatment often become radioactive. I feel this most often around other chaplains. I am sure that senior leaders probably feel the same way when they are around others who either do not have the experience or who are trying to bury theirs.

One thing that I do think would be helpful is that instead of promoting stigma would be to stand alongside each other. Relationships are key to this and while professional help is good the only thing that can take away the stigma is to get back to standing beside each other in crisis rather than abandoning those who struggle. We are the willing participants in a zero defect culture which sees struggle as weakness and a mark of failure. The sad thing is that under our current system many of the greatest military leaders in history would not be promoted. It is no wonder the leaders who we have invested so much in developing and have sacrificed so much of themselves do not seek help.

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I like the example of Ulysses Grant and William Tecumseh Sherman. Both had significant problems after they left the Army after the Mexican War and in the early days of the Civil War. Grant struggled with drinking and Sherman suffered terrible depression. Sherman said of their relationship: “Grant stood by me when I was crazy, and I stood by him when he was drunk, and now we stand by each other.”

The reality is that in today’s more corporate military culture that neither of these men would have ever been promoted to high command. They would have been shunted aside.

Something has to change if we are to end this terrible scourge. I hope that General Ham and General Chiarelli are working with mental health professionals are able to help change the culture, but then by themselves they cannot. That has to start as we say in the Navy “at the deck plates.” It is up to us to change our culture, to be warriors who look after our fellow warriors in their time of need and who by our actions take away the stigma that keeps our brothers and sisters from getting help.

Peace

Padre Steve+

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2 Comments

Filed under iraq,afghanistan, Military, News and current events, PTSD

2 responses to “Ending the Stigma: PTSD, TBI and Moral Injury in Senior Leaders

  1. patrinsinger

    Padre Steve –
    Appreciate your blog. For 5 years now, since April 2009 when my son succumbed to suicide trying to access the Tricare ‘System,’ my wife and I have been trying to get DoD leaders to hear us about the issues of mental health access, PTSD, evaluation and treatment. Andrew wasn’t active duty, he was my son who spent his entire life in the military as I served. But we are not looking at family member suicides, another large group affected by leadership gaps. It seems I, too, became “radioactive.” I retired two years ago exasperated military and DoD leadership were ostracizing me to avoid addressing the truth. Unfortunately, as you said, leaders in position to make real change are often the last people to seek help. In fact, they push anyone away who is threatening the ‘status quo.’ The root causes of suicide are in our military culture of short command assignments and perception of adversely affecting the next promotion if we speak out for culture change. This includes meeting the needs of a troop with mental health needs who are cast aside as a ‘behavior problem’ with an Administrative Discharge, often leading to suicide. It shouldn’t take another tragedy to make the necessary and required changes. But how do we get traction? My wife and I wrote to Lieutenant General Peter Chiarelli, and four other generals, but got no response. Has he really “taken up the cause to reduce the stigma,” or simply asked for a new definition of PTS? People in this country, military or civilian, shouldn’t have to have “a complete crash to get help.” Yes, let’s “stand alongside each other rather than abandoning those who struggle. Something has to change. It is up to us to change our culture…” from the outside-in.
    Peace Back

    • padresteve

      Sir,

      Thank you for your kind words and wisdom. Thank you for also sharing your loss with me and those that read this article. I do hope that LTG Chiarelli is really on board with this. I am taking him at his word, but the proof will be in actions and real leadership. As you so correctly noted this takes a culture change, not just in the military but access society. No one should have to die by their own hand because they cannot get help and lose hope. It has to be an one for all and all for one effort if it is to have any real effect.

      Peace and blessings

      Steve+

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