San Diego Magazine / August 2005 / Front Pages

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Front Pages

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Ghost Busters

Post-combat counseling helps Camp Pendleton Marines exorcise the horrors of war.

Edited by Thomas K. Arnold

“We see a guy in a wheelchair, a guy on crutches, one arm . . . and we break our backs trying to help him. But what about the wounds you can’t see? The phantoms, the nightmares, the ghosts in your head?”

THOSE WORDS ARE IN A LETTER from a returning Korean War soldier, published in Andrew Carroll’s Behind the Lines, a book of war letters. But they apply equally to the thousands of troops returning from the war in Iraq to Camp Pendleton, home base of more than 220 of the 1,600-plus military men and women killed since the war began in the spring of 2003.

To help those who survived deal with their phantoms, nightmares and ghosts, the Department of Defense now requires Camp Pendleton Marines to attend post-combat counseling sessions. Lieutenant Brian Weigelt, a chaplain with the 3rd Assault Amphibian Battalion, moderates sessions and says his primary message is for Marines to take responsibility for their emotional health.

“I try to instill in them this need for us to be as defiant and vigilant against the enemy at home as we were in Iraq,” he says. “If our lives fall apart here at home, they’ve won.”

The sessions at Camp Pendleton are part of a national Department of Defense mandate, issued in January, which requires returning sailors and Marines to participate in three follow-up meetings to catch early signs of post-traumatic stress disorder (PTSD). The follow-ups are an expansion of the military’s Warrior Transition Program, created to help with the transition back to life in the United States after combat. The program now includes predeployment education for military and their families about combat stress and continual education about PTSD on the ground in Iraq.

“I think there was this recognition by the line leadership in the Marines that coming back from war is a process, not something that can be dealt with by talking about it once,” says Navy Captain Eric McDonald, medical supervisor for the 1st Marine Expeditionary Force at Camp Pendleton.

Military psychologists expect PTSD to be a significant mental health problem in returning troops. A study by the Department of Veterans Affairs, published last March in the New England Journal of Medicine, found that as many as one in four veterans of Iraq and Afghanistan treated at Veterans Affairs hospitals in the previous 16 months was diagnosed with a mental disorder. PTSD was the most common diagnosis.

Witnessing the aftermath of violence or death increases the risk of PTSD. In Iraq, 86 percent of soldiers report knowing someone who has been seriously injured or killed, according to the V.A.

The post-combat sessions occur either in a group or individually. Especially for Marines, the emphasis on talking about feelings and asking for help represents a departure from their usual stoic, macho culture.

“It’s important for junior troops to be able to share their thoughts about combat without commanding officers around,” McDonald says. “We want them to feel comfortable talking about problems they may be having.”

McDonald recalls a speech he attended recently at the National Center for PTSD. The doctor giving the talk treated Vietnam veterans and usually asked his clients why they had never discussed their problems with a health-care provider. “The answer he got was that no one asked,” McDonald says. “People back from war don’t want to burden their friends and family with this.

“Now we are making it okay to talk about it.”