Military Suicides: Part 2

Today begins an in-depth look into a study on military suicide recently released by the Center for a New American Security (CNAS).  According to their website, CNAS is an “independent and nonpartisan research institution”, which “develops strong, pragmatic and principled national security and defense policies.”

CNAS is the only Washington think tank led by veterans of the wars in Iraq and Afghanistan.  It has conducted research on military wellness since 2008 because CNAS believes keeping our forces physically and emotionally healthy is vital for national security.  CNAS is also a close partner with Michelle Obama and Jill Biden in their valuable Joining Forces Initiative.

Joining Forces is “a comprehensive national initiative to mobilize all sectors of society to give our service members and their families the opportunities and support they have earned” and focuses on issues of employment, education, and wellness.  As part of the initiative, CNAS hopes to “build and strengthen the network of government agencies, nonprofit organizations, community and philanthropic institutions, businesses and individuals and help them connect in meaningful ways with those who have served.”

That’s a lot of background, but I want you to understand the importance and expertise of this group so committed to our nation’s forces and their families.  Their recent report, “Losing the Battle: The Challenge of Military Suicide”, by Dr. Margaret C. Harrell and Nancy Berglass, tackles our unfolding tragedy head-on, providing accurate statistics and information, as well as recommendations for the future.

Harrell and Berglass reviewed materials from the Departments of Defense and Veterans Affairs, and from independent studies, to gather up-to-date facts and statistics on military suicide.  They reported the numbers I quoted in last week’s post for veteran suicides – including the finding that one veteran takes his life every 80 minutes – but added, “It is impossible, given the paucity of current data, to determine the suicide rate among veterans with any accuracy.”  Then they add the disturbing statistic that although veterans make up only 1 percent of the population, veteran suicides represent 20 percent of all suicides in America.

Harrell and Berglass also researched suicide rates among service members.  Their findings are as alarming for personnel on active duty as for veterans.

1. Between 2005 and 2010, service members took their own lives at a rate of approximately one every 36 hours

2. Army suicides have been rising steadily since 2004, to a record high of 33 deaths in July of 2011 among active and reserve soldiers

3. Marine Corps suicides have increased steadily from 2006, dipping only slightly in 2010

4. Air Force suicides have increased significantly since 2007

5. Soldiers who deploy to Iraq and Afghanistan are more likely to commit suicide than those who do not deploy

6. There are definitive links between suicide and injuries suffered during deployment

7. Traumatic brain injury (TBI) sufferers are 1.5 times more likely to die from suicide

8. Suicide risk among service members is heightened by factors which include chronic pain, post-traumatic stress disorder (PTSD), depression, anxiety, sleep deprivation, substance abuse, and difficulties with anger management

In their report, Harrell and Berglass propose three protective factors that can help a traumatized individual resist the lure of suicide.  They suggest that people who experience both belongingness and usefulness, and have an aversion to pain or death are less likely to take their own life in response to overwhelming emotions or circumstances.  They believe that, in the past, military service included these protective qualities, but now see the changing nature of military service in Iraq and Afghanistan as having actually weakened these three factors.

Military personnel have long felt a strong sense of belonging within their units.  The close-knit camaraderie and team spirit, the code of leaving no one behind, went a long way toward strengthening service members emotionally and psychologically.  Our current wars don’t stick with this pattern, in that units are formed, deployed, and then quickly dissolved after returning from deployment.  Returning Guardsmen and Reservists disband directly back into their communities.  Vital supportive relationships with peers and superiors are lost.

Usefulness in traditional military service included the regular assignment of significant responsibilities and important tasks to relatively junior personnel.  High levels of responsibility and interaction among unit members gave a sense of value and purpose to each member’s contributions.  “In contrast”, Harrell and Berglass report, “the experience of living in a garrison environment or returning to a civilian job, or worse, unemployment, can introduce feelings of uselessness.”  Individual accounts and interviews “show that individuals withdrew, felt disconnected from their units and their families, and perceived themselves as a burden.”  My experience in treating veterans confirms these experiences and perceptions are common and widespread.

Aversion to pain and death – the third protective factor – has always been problematic for military suicide because “military service is one of the few experiences that can override this factor”.  Repeated exposure to the trauma of combat, repeated deployments, witnessing violence and death 24/7 in country in Iraq and Afghanistan, has greatly intensified the traumatic experiences of our military personnel.  To cope and remain effective, many say, they must go numb and consider themselves “already dead”.  This mindset, while it may seem necessary for survival, purposefully and completely erodes any aversion to death.

I’ve taken a lot of space today to share with you the findings of the CNAS report.  I think this information is extremely important and vital for all of us to know.  It disturbs me that the only coverage of this report that I’m aware of occurred in the Huffington Post.  All our local newspapers and media outlets should have reported this.

I agree with CNAS that all aspects of military personnel wellness are vital to our national security.  If you’ve been reading my recent blogs, you know I think it’s also a responsibility and obligation for our government and for each one of us as American citizens.  We must all commit to restoring our returning OEF and OIF forces to health and wholeness.

Next week: vital and on-target recommendations from “Losing the Battle: The Challenge of Military Suicide”.

Good News, Bad News

Your heart is pounding, your palms are sweaty, you’re short of breath and you’d like to either scream or jump up and down.  Bad news: your company just announced another wave of lay-offs and you wonder if you’re about to lose your job.

Your heart is pounding, your palms are sweaty, you’re short of breath and you’d like to either scream or jump up and down.  Good news: you’re strapped into your seat, having a great time spinning through the air on the Zipper carnival ride at the Sonoma County Fair.

Wait a minute.  How can your body respond in almost exactly the same way to two very dissimilar situations?  How can the sensations aroused by two distinctly different emotions feel so much the same?

The two distinctly different emotions I’m talking about are anxiety and excitement.  In her recent Psychology Today article, “Make Your Own Luck”, (which I’ve been blogging about recently), author Rebecca Webber makes five suggestions for making the most of the unexpected, fortuitous events that cross our life-paths.  To start off her discussion about point #3, “Say Yes”, Webber makes the observation that anxiety and excitement, or intrigue, are connected.

When a “juicy” opportunity comes along, Webber states, we can be “immediately besieged by two competing emotions: intrigue and anxiety.”  “You’re curious about that job opening,” she continues, “but you can think of a hundred reasons why you should stick with your current gig.”

When we encounter something new, each of us instinctively responds in similar ways.  Since the new person, place, event, or idea could possibly be either good news or bad news, our minds and bodies go on alert in order to assess the situation.  The phone rings; the caller ID is unfamiliar.  We say hello cautiously and hear the voice of an old friend we haven’t heard from for awhile.  We relax; all is well – very good in fact.

Or, the caller on the other end of the line is a bill collector, threatening to repossess our car.  Our initial alert status goes into fully-armored protection mode.  We need all our wits and defenses instantly operational to respond to this attack.

One of the consequences of unresolved painful issues in life – past trauma that has not healed – is that our ability to accurately “read” possibly threatening situations gets damaged.  Opportunities and fortunate events can look like danger to avoid, and, conversely, dangerous situations can masquerade as harmless and benign.  Trauma damages our emotional “radar” such that we have trouble seeing reality the way it really is.

But we can make an effort to counteract our overly fearful or cautious tendencies if we are aware of them.  Can we prime ourselves to be more open to serendipity – to fortuitous chance?  Webber points out in her article that “serendipitous people are more fearless about trying something new.  Instead of giving in to worry about what could go wrong, they think, ‘Isn’t that interesting?  I’d like to give that a try.'”

I agree strongly with her next statement: “Good outcomes increase self-efficacy, or the belief that you are capable of accomplishing whatever you set out to do; they also fuel an appetite for future risk.”  I would translate this by saying that every time you challenge yourself to take a promising risk, and are able to make it work out well for you, it will get easier to tackle the next attractive opportunity.

I see this happen all the time with my patients: the ones who improve their lives and relationships are the ones who motivate themselves to move through their fear and anxiety to discover excitement and joy.  Sometimes they stumble, sometimes they misread situations, but they also make incredible strides forward into the lives they’ve always dreamed of living.

So, the next time a heart-pounding, sweaty-palm moment comes your way, ask yourself, “Am I anxious, or excited?  Which response does this new situation call for?”  Is it good news or bad news?  If there’s any way it could be good news, take the risk.  Step out.  Don’t wait to feel comfortable.  Faced with the new, the exciting, or the unexpected, waiting to feel comfortable is a dead end.  Stay on track, don’t get stuck, and embrace our unpredictable, uncontrollable, but infinitely wonderful world.