Military resilience, suicide, and post-traumatic stress: What's behind it all?

By Dr. Frank J. Tortorello, Jr. and Dr. William M. Marcellino

Source: Foreign Policy
Published: Thursday 21 March, 2013

What's causing rises and falls in suicide, PTSD, and other socially negative outcomes for U.S. service members? We recently completed a research project in the Marine Corps sponsored by the Training and Education Command and the Center for Advanced Operational Culture Learning aimed at understanding how Marines understand stress and resilience. The results we reported suggest that the issue is not so much medical as social, cultural, and personal. Typical explanations of stress from a medical perspective suggest broken biology (defective genes or an IED blast) or compromised psychology (a psychological disposition or traumatic event). But this study found instead crises of meaning: "How can I be a good Marine and be a good parent?" or "How can I be a good Marine if I have let another Marine die?" This is a single study, and we didn't talk to every Marine. But we think this central insight has broad explanatory power for some problems Marines and other servicemembers face.

When we asked, Marines in the study told us in great detail what stress and distress are for them, and how they deal (or don't) with it. At one end of the scale are Marines equipped to do resilience work -- actively getting themselves back to a good state after distress. They can, for example, forgive themselves for battlefield errors. At the other end are ones who do not know how to (or choose not to) forgive themselves for real or imagined failures, standing in judgment of themselves. And in the middle are those Marines who are making it, but nagged by doubts about their worth or standing.

As these Marines told it, stress is variable and contextual, and what is debilitating for one Marine isn't noteworthy for another. According to them, there's nothing inherently traumatizing about seeing or inflicting death; instead, these -- like all human action -- present an interpretive choice: "I did what I had to do," vs. "I'm a murderer." Which meaning is made depends on the Marine and their context.

All of this hinges on a fundamental question about the role of our biology: Is it an important resource for making meaning, or is it a mechanism that causes us to make certain meanings? The answer dictates what legitimately constitutes data, and methods of data collection and analysis in research. Typically we see researchers who work from a medical perspective, even when claiming not to reduce humans to their biology, writing as if biology causes certain social meanings. Only with this assumption does it make sense to ignore whole persons in favor of parts of their biology or psychology.

On what scientific basis, we ask, are quantifiable bio-phenomena substituted for what a Marine says in explaining his or her stress? How are urinary free-cortisol levels more relevant for explaining and understanding PTSD than a Marine's explanation that he's accountable for another's death, and so doesn't deserve to live? That those with PTSD might have altered catecholamine and cortisol levels is not in question, but rather why researchers accord this primary focus or decisive weight in explaining what otherwise appear to be issues of personal meaning.

Just as important are this question's implications for interventions. If military members are only biomechanical creatures, then currently funded research in areas like anti-depressant nasal sprays or omega-3 fatty acid levels, and proposed funding for research in stellate ganglion blocks, are all good investments of public tax dollars. If instead military members are whole persons living in socio-cultural contexts that actively try to make sense of their lives, then we are better off researching how to train, equip, and prepare them for likely challenges to their values and worth, as they understand them. Our research tells us that there is a lot of preparation already going on: Parents, coaches, good mentors and peers all help Marines come up with strategies to avoid becoming dis-stressed, and ways to re-balance if they do. Resilient Marines can articulate where they learned such strategies, and how they employ them. But all this is ad hoc and private. The services do a good job consistently and publically preparing military members for combat and operational stress, but members are more than simply their duties. The services could do just as much to prepare and support them in the wider scope of living.

Dr. Frank J. Tortorello, Jr. is a contracted socio-cultural anthropologist who develops and researches foundational issues that impact the Marine Corps's global deployment and war fighting capabilities. Dr. Tortorello focuses on Marine Corps culture and how the Corps replicates its values through training and everyday work. His research examines how Marine Corps culture both enhances and detracts from its ability to deploy globally across the spectrum of missions from conventional warfare to humanitarian relief. He has a special interest in resilience training, defined as managing value conflicts and ethics in warfare, and in the assessment of the impact of cultural training on Marine Corps operations.

Dr. William M. Marcellino is a contracted researcher in sociolinguistics and discourse analysis, who provides research support for the USMC's Center for Advanced Operational Culture Learning. His research focus is in resilience and cohesion issues, and he is a former U.S. Marine Corps officer and enlisted. The views presented in this work are the authors and do not necessarily reflect those of the Department of Defense, the U.S. Government, or ProSol, LLC.

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