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http://www.armytimes.com/news/2008/11/gns_ham_ptsd_112508/
4-star speaks out on struggle with PTSD
By Tom Vanden Brook - USA TODAY
Posted : Tuesday Nov 25, 2008 18:54:03 EST
Gen. Carter Ham was among the best of the best — tough, smart and strong — an elite soldier in a battle-hardened Army. At the Pentagon, his star was rising.
In Iraq, he was in command in the north during the early part of the war, when the insurgency became more aggressive. Shortly before he was to return home, on Dec. 21, 2004, a suicide bomber blew himself up in a mess hall at a U.S. military base near Mosul and killed 22 people, including 14 U.S. troops. Ham arrived at the scene 20 minutes later to find the devastation.
When Ham returned from Mosul to Fort Lewis, Wash., in February 2005, something in the affable officer was missing. Loud noises startled him. Sleep didn’t come easily.
“When he came back, all of him didn’t come back. Pieces of him the way he used to be were perhaps left back there,” says his wife, Christi. “I didn’t get the whole guy I’d sent away.”
Today, Ham, 56, is one of only 12 four-star generals in the Army. He commands all U.S. soldiers in Europe. The stress of his combat service could have derailed his career, but Ham says he realized that he needed help transitioning from life on the battlefields of Iraq to the halls of power at the Pentagon. So he sought screening for post-traumatic stress and got counseling from a chaplain. That helped him “get realigned,” he says.
“You need somebody to assure you that it’s not abnormal,” Ham says. “It’s not abnormal to have difficulty sleeping. It’s not abnormal to be jumpy at loud sounds. It’s not abnormal to find yourself with mood swings at seemingly trivial matters. More than anything else, just to be able to say that out loud.”
The willingness of Ham, one of the military’s top officers, to speak candidly with USA TODAY for the first time about post-traumatic stress represents a tectonic shift for a military system in which seeking such help has long been seen as a sign of weakness.
It’s also a recognition of the seriousness of combat stress, which can often worsen to become post-traumatic stress disorder.
Ham is one of as many as 300,000 Iraq and Afghanistan combat veterans who have suffered from combat stress, according to a study by the RAND Corp. From 5 percent to 20 percent of the 1.8 million troops who have served there will have some symptoms, says Rear Adm. David Smith, Joint staff surgeon. The problems range from loss of sleep to homelessness and suicide.
A 2006 study conducted by Bruce Dohrenwend, then chief of research at the New York State Psychiatric Institute, said 20 percent of Vietnam veterans suffered from post-traumatic stress disorder.
That means 540,000 of the 2.7 million U.S. troops who were in Vietnam could have suffered from post-traumatic stress disorder (PTSD).
Adm. Michael Mullen, chairman of the Joint Chiefs of Staff, doesn’t want troops to come home without the mental health care they need after months killing insurgents, dodging bullets and bombs, and watching comrades die or get maimed.
“This isn’t just a debt of gratitude,” he says. “This is a debt that must be repaid because they’ve sacrificed so much. They’ve done exactly what this country has asked. They’ve fought and suffered, and their lives have been affected forever.”
Mullen calls Ham’s decision to speak publicly about stress “huge” and says it could help reduce the stigma many servicemembers feel about seeking help for mental health issues.
Ham is “a very senior guy,” Mullen says. “I know him well; he worked here. He understands it. He’s obviously a leader at the most senior level we have in the military. That example is one that would stand out for every soldier, sailor, airman, Marine of any pay grade, officer and enlisted who have been through combat.”
A death ‘affects all of us’
Roadside bombs, suicide attacks, snipers — the anytime, anywhere tactics of militants in Afghanistan and Iraq — require vigilance and make stress a constant companion for troops there, says Brig. Gen. Keith Gallagher, who commands Army health care facilities throughout Europe, including the Landstuhl Regional Medical Center in Germany.
Landstuhl treats troops seriously wounded in Iraq or Afghanistan. Attacks from improvised explosive devices (IEDs) sear themselves into memory.
“It’s close combat,” Gallagher says. “Unfortunately the IED blast mangles people. They see those things. Then, of course, when you lose a friend, a fellow soldier, that affects all of us. We mourn for their loss. We certainly look at the accomplishments of that soldier, the lost life, the future. That affects the mental well-being of our soldiers.”
The stress differs depending on a soldier’s proximity to the fight, says James Martin, a professor of social work at Bryn Mawr College, retired Army colonel and expert on military culture.
“The physical stress associated with being shot at in combat is a different kind of stress than the emotional stress of the leader who is sending the folks out this way,” Martin says. “It’s the difference of being in a car accident and witnessing it.”
Both types of stress can erode soldiers’ mental health, Martin says, adding that returning troops need to be monitored closely. “This is health screening,” he says. “This is analogous to knowing your cholesterol level.”
Gallagher urges soldiers to think of getting counseling as being no different than treating a muscle pulled while running.
“I’ve got pain. I’m going to go get help,” he says. “Our soldiers need to know they can freely get help without any retribution.”
Getting troops to acknowledge vulnerability will take time, Ham says. “The hard part now is changing the culture that says it’s OK to go seek help,” he says. “It doesn’t mean you’re a bad person, and it certainly doesn’t mean you’re a bad soldier.”
Anxiety after coming home
After Ham returned from Iraq, he joined the Joint staff at the Pentagon. He filled out a questionnaire about his combat tour but wasn’t examined. He brushed aside problems he had sleeping, as well as his brooding and jumping “through the ceiling” when a car backfired.
“I never thought anything about it,” he says.
His wife, Christi, did. At first, she, too, dismissed it as a reaction to his new assignment and their move to Washington, D.C., from Fort Lewis, Wash. She recognized the warning signs she had urged the wives of young soldiers to be wary of: long silences in which Ham appeared to be considering weighty decisions and the inability to enjoy pastimes such as playing with the family dog, Maggie, a chocolate Labrador.
“I had to turn the mirror on us,” she says. “I was seeing in him the very same things that I was worried that those folks might see in their spouses.”
The mess-hall bombing stands out in Carter Ham’s mind. “Not a day goes by when I don’t think about it,” he says. But the cumulative effect of making decisions that put troops in harms’ way gnawed at him as well.
“You’d get to the middle of the month and you’d say, ‘You know, we haven’t had anybody killed this month. Can we get through one month? Can we get through just one month without getting somebody killed?’ “
Brig. Gen. Gary Patton had similar experiences in Anbar province in 2004 when Sunni insurgents and al-Qaeda in Iraq terrorists gathered strength and unleashed a barrage of roadside bombs, rocket-propelled grenades and suicide attacks. Patton, then a colonel, commanded a brigade of 4,100 soldiers in Ramadi. Insurgents killed 69 of his soldiers and wounded many more.
“You also have the trauma of seeing loss of life, Iraqi citizens, innocents, being blown up by suicide bombs,” Patton says. “You had the trauma of killing another human being. We killed a lot of terrorists and insurgents in direct combat and gunfights.”
The trauma followed him home to Fort Carson, Colo. There, he says, he had difficulty turning off the vigilance that helped him survive in Iraq.
“You go from driving in a vehicle and scanning to the front and to the side for signs of snipers, RPG shooters and IED signs,” Patton says. “I couldn’t ride with my son as a passenger in a car. He’s a very good driver, but it was just that kind of vehicle anxiety. I just couldn’t get comfortable.”
Like Ham, Patton had trouble sleeping. He awoke to sounds of what he thought were explosions. In reality, they were echoes from his tour in Iraq.
A mental health screening and an “in-depth” talk with a counselor helped him understand that his reactions were common. Talking about it, Patton says, is incumbent on military leaders.
“You want your soldiers to feel you’re not alone,” he says. “There are other people experiencing these things. You’re not going crazy. I’m not going to say it’s normal, but they are expected outcomes of being exposed to this kind of trauma over an extended period of time.”
Ham says he began to acknowledge his symptoms during a session set up by Lt. Gen. James Dubik, the former head of the Multi-National Security Transition Command-Iraq, for senior leaders. Dubik wanted the top commissioned and non-commissioned officers to speak openly about the stress. Not everybody got on board, Ham says. Military tradition doesn’t easily tolerate talk of vulnerability.
“There were a couple folks who said, ‘I don’t need this,’” Ham says. “ ‘I’m a tough airborne Ranger infantryman, just get on with life.’ Those, frankly, are the guys that I worry about. There clearly is a part of Army culture that says, ‘Tough it out. You just work your way through it.’ That’s clearly where I thought I was. I didn’t think I needed anybody to help me. It took the love of my life to say, ‘You need to talk to somebody.’ I’m glad that she did that, and I think she’s glad that I did that.”
Talks with a chaplain he trusted helped Ham understand that his mood swings and trouble sleeping were normal responses to the stress, particularly memories of the mess-hall bombing.
Gradually, over a period of months, Christi Ham recognized more and more of the man she’d been married to for 32 years.
“Some things come back quicker or in different ways,” she says. “But that gives you the little ray of hope that if that piece is changing, then he understands it, and the rest of it will follow. There’s no quick bullet.”
When Carter Ham began playing with the dog again, Christi knew he was recovering. “To be able to see him to respond,” she says, her voice trailing off. “It let you know what he missed.”
4-star speaks out on struggle with PTSD
By Tom Vanden Brook - USA TODAY
Posted : Tuesday Nov 25, 2008 18:54:03 EST
Gen. Carter Ham was among the best of the best — tough, smart and strong — an elite soldier in a battle-hardened Army. At the Pentagon, his star was rising.
In Iraq, he was in command in the north during the early part of the war, when the insurgency became more aggressive. Shortly before he was to return home, on Dec. 21, 2004, a suicide bomber blew himself up in a mess hall at a U.S. military base near Mosul and killed 22 people, including 14 U.S. troops. Ham arrived at the scene 20 minutes later to find the devastation.
When Ham returned from Mosul to Fort Lewis, Wash., in February 2005, something in the affable officer was missing. Loud noises startled him. Sleep didn’t come easily.
“When he came back, all of him didn’t come back. Pieces of him the way he used to be were perhaps left back there,” says his wife, Christi. “I didn’t get the whole guy I’d sent away.”
Today, Ham, 56, is one of only 12 four-star generals in the Army. He commands all U.S. soldiers in Europe. The stress of his combat service could have derailed his career, but Ham says he realized that he needed help transitioning from life on the battlefields of Iraq to the halls of power at the Pentagon. So he sought screening for post-traumatic stress and got counseling from a chaplain. That helped him “get realigned,” he says.
“You need somebody to assure you that it’s not abnormal,” Ham says. “It’s not abnormal to have difficulty sleeping. It’s not abnormal to be jumpy at loud sounds. It’s not abnormal to find yourself with mood swings at seemingly trivial matters. More than anything else, just to be able to say that out loud.”
The willingness of Ham, one of the military’s top officers, to speak candidly with USA TODAY for the first time about post-traumatic stress represents a tectonic shift for a military system in which seeking such help has long been seen as a sign of weakness.
It’s also a recognition of the seriousness of combat stress, which can often worsen to become post-traumatic stress disorder.
Ham is one of as many as 300,000 Iraq and Afghanistan combat veterans who have suffered from combat stress, according to a study by the RAND Corp. From 5 percent to 20 percent of the 1.8 million troops who have served there will have some symptoms, says Rear Adm. David Smith, Joint staff surgeon. The problems range from loss of sleep to homelessness and suicide.
A 2006 study conducted by Bruce Dohrenwend, then chief of research at the New York State Psychiatric Institute, said 20 percent of Vietnam veterans suffered from post-traumatic stress disorder.
That means 540,000 of the 2.7 million U.S. troops who were in Vietnam could have suffered from post-traumatic stress disorder (PTSD).
Adm. Michael Mullen, chairman of the Joint Chiefs of Staff, doesn’t want troops to come home without the mental health care they need after months killing insurgents, dodging bullets and bombs, and watching comrades die or get maimed.
“This isn’t just a debt of gratitude,” he says. “This is a debt that must be repaid because they’ve sacrificed so much. They’ve done exactly what this country has asked. They’ve fought and suffered, and their lives have been affected forever.”
Mullen calls Ham’s decision to speak publicly about stress “huge” and says it could help reduce the stigma many servicemembers feel about seeking help for mental health issues.
Ham is “a very senior guy,” Mullen says. “I know him well; he worked here. He understands it. He’s obviously a leader at the most senior level we have in the military. That example is one that would stand out for every soldier, sailor, airman, Marine of any pay grade, officer and enlisted who have been through combat.”
A death ‘affects all of us’
Roadside bombs, suicide attacks, snipers — the anytime, anywhere tactics of militants in Afghanistan and Iraq — require vigilance and make stress a constant companion for troops there, says Brig. Gen. Keith Gallagher, who commands Army health care facilities throughout Europe, including the Landstuhl Regional Medical Center in Germany.
Landstuhl treats troops seriously wounded in Iraq or Afghanistan. Attacks from improvised explosive devices (IEDs) sear themselves into memory.
“It’s close combat,” Gallagher says. “Unfortunately the IED blast mangles people. They see those things. Then, of course, when you lose a friend, a fellow soldier, that affects all of us. We mourn for their loss. We certainly look at the accomplishments of that soldier, the lost life, the future. That affects the mental well-being of our soldiers.”
The stress differs depending on a soldier’s proximity to the fight, says James Martin, a professor of social work at Bryn Mawr College, retired Army colonel and expert on military culture.
“The physical stress associated with being shot at in combat is a different kind of stress than the emotional stress of the leader who is sending the folks out this way,” Martin says. “It’s the difference of being in a car accident and witnessing it.”
Both types of stress can erode soldiers’ mental health, Martin says, adding that returning troops need to be monitored closely. “This is health screening,” he says. “This is analogous to knowing your cholesterol level.”
Gallagher urges soldiers to think of getting counseling as being no different than treating a muscle pulled while running.
“I’ve got pain. I’m going to go get help,” he says. “Our soldiers need to know they can freely get help without any retribution.”
Getting troops to acknowledge vulnerability will take time, Ham says. “The hard part now is changing the culture that says it’s OK to go seek help,” he says. “It doesn’t mean you’re a bad person, and it certainly doesn’t mean you’re a bad soldier.”
Anxiety after coming home
After Ham returned from Iraq, he joined the Joint staff at the Pentagon. He filled out a questionnaire about his combat tour but wasn’t examined. He brushed aside problems he had sleeping, as well as his brooding and jumping “through the ceiling” when a car backfired.
“I never thought anything about it,” he says.
His wife, Christi, did. At first, she, too, dismissed it as a reaction to his new assignment and their move to Washington, D.C., from Fort Lewis, Wash. She recognized the warning signs she had urged the wives of young soldiers to be wary of: long silences in which Ham appeared to be considering weighty decisions and the inability to enjoy pastimes such as playing with the family dog, Maggie, a chocolate Labrador.
“I had to turn the mirror on us,” she says. “I was seeing in him the very same things that I was worried that those folks might see in their spouses.”
The mess-hall bombing stands out in Carter Ham’s mind. “Not a day goes by when I don’t think about it,” he says. But the cumulative effect of making decisions that put troops in harms’ way gnawed at him as well.
“You’d get to the middle of the month and you’d say, ‘You know, we haven’t had anybody killed this month. Can we get through one month? Can we get through just one month without getting somebody killed?’ “
Brig. Gen. Gary Patton had similar experiences in Anbar province in 2004 when Sunni insurgents and al-Qaeda in Iraq terrorists gathered strength and unleashed a barrage of roadside bombs, rocket-propelled grenades and suicide attacks. Patton, then a colonel, commanded a brigade of 4,100 soldiers in Ramadi. Insurgents killed 69 of his soldiers and wounded many more.
“You also have the trauma of seeing loss of life, Iraqi citizens, innocents, being blown up by suicide bombs,” Patton says. “You had the trauma of killing another human being. We killed a lot of terrorists and insurgents in direct combat and gunfights.”
The trauma followed him home to Fort Carson, Colo. There, he says, he had difficulty turning off the vigilance that helped him survive in Iraq.
“You go from driving in a vehicle and scanning to the front and to the side for signs of snipers, RPG shooters and IED signs,” Patton says. “I couldn’t ride with my son as a passenger in a car. He’s a very good driver, but it was just that kind of vehicle anxiety. I just couldn’t get comfortable.”
Like Ham, Patton had trouble sleeping. He awoke to sounds of what he thought were explosions. In reality, they were echoes from his tour in Iraq.
A mental health screening and an “in-depth” talk with a counselor helped him understand that his reactions were common. Talking about it, Patton says, is incumbent on military leaders.
“You want your soldiers to feel you’re not alone,” he says. “There are other people experiencing these things. You’re not going crazy. I’m not going to say it’s normal, but they are expected outcomes of being exposed to this kind of trauma over an extended period of time.”
Ham says he began to acknowledge his symptoms during a session set up by Lt. Gen. James Dubik, the former head of the Multi-National Security Transition Command-Iraq, for senior leaders. Dubik wanted the top commissioned and non-commissioned officers to speak openly about the stress. Not everybody got on board, Ham says. Military tradition doesn’t easily tolerate talk of vulnerability.
“There were a couple folks who said, ‘I don’t need this,’” Ham says. “ ‘I’m a tough airborne Ranger infantryman, just get on with life.’ Those, frankly, are the guys that I worry about. There clearly is a part of Army culture that says, ‘Tough it out. You just work your way through it.’ That’s clearly where I thought I was. I didn’t think I needed anybody to help me. It took the love of my life to say, ‘You need to talk to somebody.’ I’m glad that she did that, and I think she’s glad that I did that.”
Talks with a chaplain he trusted helped Ham understand that his mood swings and trouble sleeping were normal responses to the stress, particularly memories of the mess-hall bombing.
Gradually, over a period of months, Christi Ham recognized more and more of the man she’d been married to for 32 years.
“Some things come back quicker or in different ways,” she says. “But that gives you the little ray of hope that if that piece is changing, then he understands it, and the rest of it will follow. There’s no quick bullet.”
When Carter Ham began playing with the dog again, Christi knew he was recovering. “To be able to see him to respond,” she says, her voice trailing off. “It let you know what he missed.”
