>LtCol Grice is a frequent contributor to the Marine Corps Gazette and is a veteran of Operations ENDURING FREEDOM and IRAQI FREEDOM. This article was written and submitted prior to LtCol Grice’s retirement.
The Marine Corps is built on tradition, and one of those traditions is the time-honored ceremony of the change of command. Every unit has a commanding officer (CO), that leader who is specially selected and solemnly charged with the awesome and humbling responsibility to mentor, train, and mold the sons and daughters of America as they wrap themselves in the cloth of the Nation in time of war. Most of these officers, like many of the Marines and sailors with whose lives they are entrusted, are veterans of war, and like anyone who has endured the rigors and terrors of combat, they too suffer within from what they have experienced.
Following the change of command ceremony the new CO, as is tradition, gathers the unit together to introduce himself and give his initial guidance. It is a pivotal moment; the newest and highest ranking member of the command must establish his expectations and chart the way ahead for the unit, and the Marines and sailors are pensive and eager to see just what mettle the new boss is made of. At one such meeting, the new CO brought the meeting to a close a bit unexpectedly by posing a question to the members of the command. “How many of you have been in combat?” It is a ground combat unit recently returned from theater, so a lot of hands go up, including his. “How many of you have posttraumatic stress disorder (PTSD)?” There are anxious and nervous looks as the Marines and sailors process the question. Hands waver and fall, until only one hand remains in the air. The sole remaining hand belongs to the Marine at the front of the room. “Well, I am your CO, and I have PTSD. A lot of you have it too, and that’s okay. We’ll get through it together.” I know firsthand about that CO’s introduction to his unit because I was the Marine at the front of the room with his hand in the air.
PTSD and its close cousin, combat operational stress, are something that sane and rational people have after being placed in exceptional situations that leave searing impressions that never really go away. In many ways it is like a chronic disease with acute symptoms that only the person who has it can see. It has been called a silent epidemic, and it is. Anyone who has survived the crucible of combat fights those battles again and again long after the last round is fired, and those battles become PTSD when they never seem to end.
In my case I really didn’t believe in PTSD until after my third combat tour. As a platoon commander I had served two highly kinetic tours in Iraq, and as an individual augment to Special Operations Command I found myself conducting operations in Afghanistan—with all three tours in less than a 36-month timespan. I didn’t think much about it at the time, but what had occurred was that my own perceptive realities had subtly shifted until my personal new normal was either preparing to deploy or deploying to a combat zone. My life at home with my family became an oddity in the grinding operational tempo that consumed my life.
As I said, I didn’t think much about it at the time until I returned from my third tour in as many years and went through the postdeployment process. During the health screening session I was handed a questionnaire that focused on deployments. It asked silly questions like “Have you been deployed to a combat zone?” Duh. “How many times?” I filled in the bubble marked “3.” “Do any of the following apply to you?” Let’s see. “Sleeplessness or restless sleep?” Yep. “Do you experience difficulties remembering things?” Yep, again. “Inability to relax?” Um, yep. “Irritability or short temper?” It was starting to get a little uncomfortable. “Do you relive combat experiences or have flashbacks?” I dropped my pencil, and I started to sweat. It hit me like a hammer. The questionnaire was describing me. I looked at it again, and at the top, unassuming letters spelled out what it was: “Posttraumatic Stress Disorder Evaluation.” Gulp. I have PTSD.
So what effect did PTSD have on me? I was always of the macho opinion that only losers had PTSD—weak-minded or weak-willed misfits who were too effete to stand up to the rigors of combat. People like that ended up on the side of the road holding up cardboard signs asking for handouts, didn’t they? The answer is that some of them did, but a lot of them didn’t. Instead, they were just like me—professional warriors who carry the responsibility of leading others into harm’s way with the specter of their life-altering experiences constantly looming overhead. There are many symptoms of PTSD—too many in fact to address in this article. In my case, though, my symptomology contained four major issues.
Sleep difficulties. I have not had a full night’s uninterrupted sleep since 2005—not at home anyway. I sleep fine in theater. At home I can fall asleep, but I wake several times each night. At first it would frighten my wife because I would jump out of bed with a gasp, but over time that has lessened, and I just snap into full wakefulness every few hours, and then try to get back to sleep, sometimes successfully, sometimes not.
Hypervigilance. It is as though I had developed adult onset attention deficit hyperactivity disorder (ADHD) because I can’t seem to sit still or relax. I have to get up and walk around when everyone else is watching television. It is compulsive because I don’t even realize I’m doing it until I am up and moving, only to wonder what I am doing pacing back and forth to the refrigerator when I’m not hungry or thirsty.
Short-term memory loss. I can’t remember anything. My recall used to be pretty sharp, but now it isn’t. I go to the pantry to get something for the dinner table and forget what it was even though I had only moved 4 feet in about 2 seconds. People think I am rude because I whip out my Blackberry in midconversation or midmeeting to type reminders into my calendar because I know that I will forget what they said if I don’t immediately record it. I have little notes everywhere, and often forget where I put them.
Reliving events. It is as though there is a continual loop of combat experiences always running through my mind—not in a crazy, gibbering idiot LSD flashback kind of way, but in a movie background music kind of way. I often find my mind wandering back to Iraq or Afghanistan, and I am often snapped back to the present when someone asks me to pass the mashed potatoes or answer a question in a meeting. My hands reach for a rifle that I turned in long ago, and my pulse quickens in response to the feeling that I am back on patrol in theater even though I’m safely on the other side of the planet.
Those are my major symptoms. As an individual I tried to cope with them and mitigate their effects while keeping my act together as a Marine. As a leader and a CO, however, my problems were subordinate to the awesome responsibility of leading Marines into combat. How could I possibly lead others when I had the monkey of PTSD on my back?
After searching my soul I decided that honesty was the best policy. After divulging my personal battles with PTSD to my unit I found, to my relief, that nobody really seemed to worry too much that the boss had issues. In fact, many approached me later to thank me for being upfront about PTSD because they felt afraid to face their own demons for fear of being perceived as crazy or weak. I reassured them that it was okay. But how could I ensure that it was okay? How could I return the spoken trust of the few who had approached me in addition to the trust that I still had to earn from those who were waiting to see if I warranted it?
As a leader there were four significant actions I took to address the issue of PTSD in the unit. The first was to demystify it publicly by announcing that I had it, and that it was okay if others had it too. In my talk with the Marines and sailors I explained that experiencing the issues associated with combat was a natural reaction to intense stress and that I would support them and help them get through it. More than an open door policy, it was an open hand that reached out and offered a nonattributional opportunity to talk to me about it. I promised to listen. Not too many Marines took me up on it, but a few did, and I believe that the rest of the unit respected my sincere invitation to help.
Second, I had a frank discussion with the leadership in the unit, from the NCOs up to the senior enlisted Marines and officers. I explained in no uncertain terms my expectations in regard to PTSD. It was not a shield for shirkers to hide behind (which never became an issue), and it was not a sign of weakness (which was a well-received message because several of them later confided in me that they had problems too). I discussed what to look for and what to do when they found it—to be watchful for changes in temperament, social withdrawal, or just the opposite for those who seemed to go off the deep end and take heedless risks. I spoke of the importance of paying close attention to family situations, such as who was having marital problems. I included the leaders in a network of concerned observers and participants on the lookout for indicators and warnings in the hopes of mitigating them before they became problems.
Third, I got out and did a lot of old-fashioned leadership by walking around. It suited my adult onset ADHD to keep moving, so I would wander into the various spaces and training areas where the Marines and sailors were. I tried to get out enough so that my presence was not regarded as a “command visit” or unusual; with my repeated visits the barriers between the members of the unit and me began to come down. I would ask them how they were doing and actually listen to their responses. I sought out those who I knew had seen a lot in combat or were exhibiting the symptoms of PTSD and talk to them, not as a commander but as a mentor to help them smooth out the rough patches. At social events like the Birthday Ball or the Christmas party I would ask the wives and girlfriends how their Marines were doing, and they would tell me and sincerely thank me for caring enough to ask.
Finally, and perhaps most importantly, I established the expectation that the unit was going back to war and that we were going to fight; that is why we all wore the uniform. If PTSD made you incapable of shouldering your pack or lifting your rifle, then I would get you the help you needed to get you back to where you needed to be, including any treatment that would help.1 However, the mission came first, and if someone could not fulfill his duties then he could not stay and join the fight, which became an integral goal for each and every Marine and sailor and actually helped combat the symptoms of PTSD by providing something to which to aspire.
As a result, I firmly believe that my unit became stronger and more cohesive because of the demystification of PTSD and acceptance that it was an expected and not abnormal response to combat experiences. The true reward came long after my initial introduction to the unit and the tour to Helmand Province that followed. It came when the trust in me earned from Marines and sailors grew to a level where they would approach me and ask how I was doing and share with me how they were getting through the tough times themselves. There is no award more valuable than the bestowment of such trust, and although another change of command saw me pass the colors to my successor, there is nothing that I will cherish more highly.
1. Several Marines, including me, were undergoing treatment at the Deployment Health Center for PTSD. Interestingly, in my 18 months or so of appointments, I saw only one other officer (a chief warrant officer with an explosive ordnance disposal badge on his chest) in the waiting room. The stigma against leaders seeking help is a strong one.