Army To Train Soldiers In Emotional Resiliency

The U.S. Army plans to add mental fitness training for soldiers to battle growing rates of depression and PTSD. Martin Seligman of the University of Pennsylvania's Positive Psychology Center and Brig. Gen. Rhonda Cornum evaluate how troops are mentally prepared for combat.

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NEAL CONAN, host:

This is TALK OF THE NATION. I'm Neal Conan in Washington. Starting next month, the Army starts a new training program to emphasize mental fitness along with physical fitness. Instead of addressing mental health issues only after the fact, this new program hopes to build emotional resilience starting in basic training.

The idea is to improve performance in combat and reduce problems like depression, post-combat stress disorder and suicide. The approach is based on positive psychology and aims to give soldiers tools to diffuse negative assumptions and emphasize resilience, but Army Chief of Staff George Casey concedes that it will be difficult to change a military culture that often regards talk about emotions as mollycoddling nonsense.

Later in the hour, we'll talk about the emotions that won't let us go eight years after 9/11. But first, positive psychology in the Army. We'll hear more about this new program, and we want to hear from those of you are now or formerly were in uniform. Tell us how this military culture works. Can we change it? Should we?

Phone number: 800-989-8255. Email us: talk@npr.org. You can also join the conversation on our Web site at npr.org. Click on TALK OF THE NATION.

We begin with Brigadier General Rhonda Cornum. She's director of Comprehensive Soldier Fitness. She oversees the new resilience program for the U.S. Army, and joins us from her office in Arlington, Virginia. Good to have you with us today.

Brigadier General RHONDA CORNUM (Director, Comprehensive Soldier Fitness, U.S. Army): Thank you.

CONAN: And General Casey has been quoted as saying: "I'm still not sure our culture is ready to accept this." Are you?

Brig. Gen. CORNUM: Well, I really think so. We have - so far, we have trained a number of people, and we have gotten feedback from all of them, most of them non-commissioned officers, who are engaged in basic training - you know, drill sergeants and platoon sergeants. And they have really been very enthusiastic that this will be helpful in preparing soldiers not just for combat, but for any challenges they face.

And those drill sergeants who conduct basic training, those are the people who really communicate Army culture.

Brig. Gen. CORNUM: Correct. And they are very adamant that it does need to be done by non-commissioned officers who otherwise do training. It shouldn't be done by some, you know, psychological or medical professional.

CONAN: And as I understand it, this program begins by training sergeants who will then go out and train other people in basic training.

Brig. Gen. CORNUM: Correct.

CONAN: And so you're going to start this at the bottom level and see how it works on its way up?

Brig. Gen. CORNUM: That's exactly right. And so for example, one of the people who I got feedback from who was briefing his commander, he says it's embraced by soldiers and leaders because it's simple, applicable to everyday life, and it is soldiers teaching and guiding fellow soldiers.

CONAN: Well, how do you teach resilience?

Brig. Gen. CORNUM: Well, now, I am not the expert at that particular task, but I understand that we may have someone else on the show who is more expert in that.

CONAN: Well, let's turn then to Martin Seligman. He's the chairman of the University of Pennsylvania's Positive Psychology Center. He joins us from his home in Philadelphia. Good to have you with us today.

Dr. MARTIN SELIGMAN (Positive Psychology Center, University of Pennsylvania): Oh, thank you Neal. Good afternoon, Rhonda.

Brig. Gen. CORNUM: Good afternoon.

CONAN: And so Martin Seligman, how do you teach resilience?

Dr. SELIGMAN: The teaching of resilience comes out of the history of cognitive therapy of depression. So starting about 30 years ago, people like Aaron Beck and Albert Ellis began to look at the catastrophic thoughts that people said to themselves when they were in very adverse situations, and often those thoughts were unrealistic.

So if you're in Iraq, for example, and you call your wife at home - this seems to be our first war in which you can make cell phone calls home - and she doesn't answer, you might think the most catastrophic thing possible: She's walked out on me.

So one of the things you teach people to do is, well, just wait a minute. That's the most catastrophic possibility. Now, what's the best possible scenario? Well, it might be that she's just taken the kids out for a walk. Okay, now, what's the most likely scenario? Well, we did have a fight yesterday. So she may have gone off to see her mother, but things are going to be all right.

So resilience begins by teaching soldiers, just as we have taught thousands of people, to recognize the most catastrophic things they say to themselves when bad events occur and to dispute them, to find the realistic causes of the bad events.

CONAN: Well, as I understand this, Martin Seligman, the training is based on techniques - you say you've taught it to thousands of people - techniques mostly tested in middle schools. How are middle schools - how does that translate to the U.S. Army?

Dr. SELIGMAN: Well, first, the techniques begin with adults. So these are the tried-and-true techniques from adults in cognitive therapy. About 15 years ago, we began to ask the question whether or not you could take the techniques of resilience and teach them to middle school kids, age 10 to 12.

So across Australia, the United States and the U.K., we've taken thousands of middle school children, taught their teachers the techniques of cognitive therapy - not in a therapeutic mode, but a preventive mode - and we found that with teachers teaching 10 to 12-year-old children, and then we do the same thing at the University of Pennsylvania with our incoming, pessimistic freshmen, we find that by teaching these techniques, we lower, markedly, the probability of depression and anxiety.

CONAN: So you think this will translate well to young men and women in the Army?

Dr. SELIGMAN: Well, it's a good hypothesis, and of course, General Cornum and I are going to be monitoring this very carefully.

CONAN: Well, General Cornum, let me ask you: How do you test to see whether this is working?

Brig. Gen. CORNUM: Well, I think you can test in very objective ways. For example, you can look in - and pretty quick ways. For example, you can look at graduation rates and performance in basic training, and this has been done in the Navy in a very scientific way in 2004, and they showed that resilience training in a - and they only did it to the least psychologically resilient at the time, but they showed that there were marked improvements in their graduation rates and their performance that those effects, even though it only happened in basic training, continued on for at least two years.

So there is some evidence already that this will actually have a positive impact, but we are intending to make everybody more fit, not just focus on the least psychologically fit of the force.

CONAN: We're talking with Brigadier General Rhonda Cornum in the U.S. Army, director of Comprehensive Soldier Fitness, oversees a new program to train basic-training recruits in resilience. And also with us, Martin Seligman of the University of Pennsylvania's Positive Psychology Center. And if you'd like to join us, how do you change military culture? Can it be changed? Should it be changed? Email is talk@npr.org. Call us: 800-989-8255. And let's start with Ronnie, Ronnie calling us from Grand Rapids in Michigan.

RONNIE (Caller): Good afternoon.

CONAN: Good afternoon.

RONNIE: Thank you for having me on. I'm glad for the opportunity. I would suggest that they do something ASAP for the military culture around mental health issues.

My daughter is a soldier. She served three tours in Iraq. She served a tour in Kuwait after that. She ran into a group that was very not sensitive to perhaps if she was showing evidence of depression, because these were back-to-back tours. And it followed her back to the United States within the same group, and I mean, she really suffered.

And prior to that, she did not have any record or any behaviors that would provoke somebody to say that she was depressed or not depressed or just she wasn't that kind of soldier. And it really did a job on her and us to keep her, maintain her, because she loved the military, and she wants to stay in it, and I just think they weren't very sensitive to what she was going through.

And, I mean, she was demoted. All kinds of things came about. And the types of punishment that they would give her, like over in Kuwait, keeping her in her room, where she didn't have any interaction with people. Is that what you do with a depressed person? Do you shut them off from the rest of the community? I just think that they really need a new approach.

And if you start the approach here in the basic training, maybe that'll help it trickle through to a sensitivity toward people - soldiers are people, too, and they have issues. And a lot of these kids that are getting in there, they don't come from backgrounds that, you know, they have those kinds of support systems or those recognitions. And I think it's wonderful to start something that will help people be more sensitive within the military.

CONAN: Well, General Cornum, as I understand it, this program that we're talking about here might have helped to give Ronnie's daughter the tools to help her cope with it, but inevitably, would it also help address the situation of lack of sensitivity to somebody experiencing depression?

Brig. Gen. CORNUM: Well, I think what it will do is it will give junior leaders and people who - you know, platoon sergeants and company commanders and platoon leaders a greater vocabulary and a greater understanding of psychological issues, whether or not it's people in crisis or it's just people who are dealing with normal life.

So I think it will be beneficial in all those aspects. You know, it's not going to teach anybody to treat anything, but I think it will give them a greater comfort level in discussing those kinds of things, just like we don't seem to have any problem discussing people's weight or people's ability to run or people's ability to do push-ups, but we - everybody just kind of gets uncomfortable right now talking about psychology.

CONAN: Martin Seligman - and Ronnie, thank you very much for the call. We wish your daughter the best.

RONNIE: Thank you.

CONAN: And Martin Seligman, give us some examples of this new vocabulary that General Cornum was talking about.

Dr. SELIGMAN: Well, so in the case of Ronnie's daughter, who - and people who might be prone to depression, by getting people to think about the catastrophic thoughts they say to themselves, by getting them conscious of the things that cause depression, the most catastrophic interpretations of bad events, you not only get a vocabulary, but the data are that programs of this sort done preventatively can circumvent the need for therapy some of the time. And roughly, we find they roughly halve the rate of depression among adolescents when they're given preventatively. So that's a good reason that this would work.

CONAN: By preventatively, you mean, you know, in advance, before she experienced the situation that might have triggered the depression.

Dr. SELIGMAN: Exactly right. Yeah.

CONAN: And that would be in basic training. And obviously, General Cornum, this is going to take some time to filter up through the ranks.

Brig. Gen. CORNUM: Well, obviously. And we are very, you know, we are trying as diligently as we can to have a program that we can get out to as many people as possible while still maintaining quality.

CONAN: We're talking with Brigadier General Rhonda Cornum of the U.S. Army, director of Comprehensive Soldier Fitness, with us from her office in Arlington, Virginia. Also with us, Martin Seligman, chairman of the of the University of Pennsylvania's Positive Psychology Center, at home in Philadelphia.

We're talking about this Army training program to help deal with mental stress and focus on mental fitness, beginning in basic training. If you are or were in uniform, tell us how military culture works. Can we change it? Should we? 800-989-8255. Email us: talk@npr.org. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. I'm Neal Conan, in Washington. U.S. Army surveys show that at least 20 percent of combat soldiers show symptoms of mental health problems like depression or PTSD. Sadly, suicide is a growing problem.

We're talking today about one of the new ways the Army is working to prevent mental health problems, by training soldiers in emotional resiliency, starting in basic training. Of course, that requires changing a military culture that often sees talking about feelings as a sign of weakness.

We want to hear from those of you now or formerly in uniform. Tell us how this military culture works. Can we change it? Should we? 800-989-8255. Email: talk@npr.org. You can also join the conversation on our Web site. That's at npr.org. Click on TALK OF THE NATION.

Our guests are Brigadier General Rhonda Cornum, director of Comprehensive Soldier Fitness, who oversees this new program, and Martin Seligman, chairman of the University of Pennsylvania's Positive Psychology Center, who's consulting the Pentagon on the training.

Let's get another caller on the line. This is Irene, Irene calling us from Fayetteville, North Carolina.

IRENE (Caller): Hi. I think it's not only important that soldiers get to understand that they can take advantage of that, those services, but that you change the culture as far as the supervisors and commanders go. Because I was, of course, in the Army before we went to war with Iraq, but even though I had a mental health issue because I had been attacked the year before, I was - discouraged is putting it mildly, of taking advantage of any sort of mental health service that I could receive.

CONAN: Discouraged? What do you mean by that?

IRENE: By my commander. I mean, there was every excuse in the book and every consequence he could possibly put on me to prevent me from going, was, you know - I was reprimanded against. That's the truth of the matter.

CONAN: And did this start with - and again, I don't mean to put words in your mouth - but did this start with hey, soldier, you've got to suck it up?

IRENE: Pretty much, yes. And it took a very long time for me to kind of realize that I needed to go. I noticed that I was doing things that were not normal for me. And so, I mean, I got to the point where I would go and sit in the parking lot of the clinic for weeks on end, day after day, and not go inside because I was afraid of what was going to happen if I did. And then when I finally decided that I had to do that - you know, then of course, you have appointments every so often, and, you know, well, now we have these things going on. And everybody else is going to have to do more work because you're not there and all this other kind of stuff until my supervisor became downright hostile about me going to these appointments.

CONAN: And let me ask, Irene, are you still in the military?

IRENE: No, no.

CONAN: And is it…

IRENE: No. And this is one of the major reasons why I'm not, because I love the Army. I would have stayed the whole 20 years, and I wasn't a 19, 20-year-old. I was an adult. I was in my mid-30s, so - and I'm not very timid, usually. So I'm not somebody who - if I know that that's the right thing to do, I'm not very easily discouraged, but there was a lot of pressure put upon me not to go to mental health.

CONAN: Irene, we wish you the best of luck. Thank you so much for the phone call.

IRENE: Thank you very much.

CONAN: Appreciate it.

IRENE: Bye-bye.

CONAN: And General Cornum, this is outside the ambit of this particular training program, but nevertheless…

Brig. Gen. CORNUM: Well, it certainly is a very - it's certainly unfortunate that that happened, and I have to say that there is a huge effort on de-stigmatizing going to get mental health assistance, I mean, from - we talk about that at every level, from the four-star conferences down to the pre-command course and down to the non-commissioned officer academies.

We are working diligently. I will not say that it is fixed, but I will say that it's vastly improved. I think more and more people are recognizing that the earlier people go in and get assistance when they need it, the better the chances that they will come out and get back to their usual level of performance. And so whether that's - you know, once again, we're trying to normalize that so that they realize it happens that way whether it's their bad blood sugar or their difficulties with some psychological issue. The earlier you get treated, the easier and more rapidly you will improve.

CONAN: Let's go next to…

Dr. SELIGMAN: It's an important point for Comprehensive Soldier Fitness that Irene raises. So in this program, soldiers learn that there's a normal distribution of emotional response to combat and adversity, anxiety and depression being a normal part of it and that most people experience those things. The great majority of them show resilience, and quite a number show post-traumatic growth, as well. So this is an attempt to de-stigmatize depressive and anxiety reactions to high adversity.

CONAN: That - Martin Seligman in there. Let's go next to Doug, and Doug's on the line from Miami.

DOUG (Caller): Hey, how are you doing, Neal? Thanks for having me on your program. I think that the problem stems a little deeper than that. I think it's a matter of screening. I'm out of the military now, but I was a member of the special operations community, and I firmly believe that the cohesiveness of your unit and the effectiveness of your unit, depending on what your job is in the military, is determined by how strong and mentally fit the soldier is.

I think it really is - depends - how strong of a person you are mentally will determine what kind of career field you can handle. And I think that it's really - you know, people that are - and I hate to sound insensitive, but people that are a little weaker and more susceptible to these kind of mental issues have no business being on the front line, and I think there should be a better job of screening soldiers into high-risk, high-exposure-to-combat career fields. I mean…

CONAN: Are you saying, Doug, that anybody who needs this kind of training shouldn't be in the military?

DOUG: No, I'm not saying that. There's plenty of jobs in the military for people who are not mentally fit to handle a combat situation.

CONAN: So they shouldn't be in combat units.

DOUG: There's plenty of jobs in the military. I mean, why is the selection process for fighter pilots so strict, and why do so few become fighter pilots? Because those people are mentally fit. They're trained, and very few of them, a small percentage, I'd be willing to put on the line less than half a percent of fighter pilots come out with some sort of mental disability.

CONAN: Martin Seligman, I wonder if you could respond to that.

Dr. SELIGMAN: Oh, I think Doug is exactly right. So there's recently published a study of 6,000 soldiers from 2002 to 2006. Three hundred and fifty, by the end, have come down with post-traumatic stress disorder. Of those 350, 58 percent of the people who come down with it were in the bottom 15 percent to begin with for mental and physical fitness. And that's part of the justification for the Army saying let's take these distribution of resilience of mental fitness and move it in the direction of resilience and strengths. So Doug has a very important point.

CONAN: And so, General Cornum, could we not address this situation with better screening, then?

Brig. Gen. CORNUM: Well, I think there's a number of points. One is - and my spouse has been in the Air Force for over 30 years. So I'm relatively well aware of what Air Combat Command does with fighter pilots. But we have several issues that are very different. One of them is that almost right now, regardless of your military occupational specialty, if you're in the Army and you deploy at all, you're at risk. I mean, if you're - you can be taking care - you can be a pediatrician or a pediatric nurse, and you are still going to be at risk because you are living close to the wire.

CONAN: And as we've learned in Iraq, there are no front lines. Truck drivers are likely - as likely to be ambushed as anybody else.

Brig. Gen. CORNUM: Right. And so it isn't a question of we could just screen out anybody who might be susceptible to stress. You know, we just - we have a huge Army, and I think what we need to do, really, is take everybody and make them as strong as we can make them.

CONAN: Doug, thanks very much for the call, appreciate it.

DOUG: Thank you.

CONAN: Bye-bye. Here's an email from Rebecca in Minneapolis. I love this idea of preventive cognitive therapy, but I wonder if soldiers who either are or become more resilient will be more likely than ever to see a mental problem in another soldier as a character flaw or somehow the fault of the individual who develops the problem. Martin Seligman?

Dr. SELIGMAN: Well, I think people's susceptibility to anxiety and depression is not a character flaw. It's very often bad habits. So people who make catastrophic interpretations of bad events are more susceptible, and that's not a character flaw. It's easy to unlearn. When people know not to think in terms of always in character and never when bad events occur, we find that that lowers the risk.

So I think this will make people more sensitive to resisting and being resilient from depression and anxiety, but not getting people to blame the character of other people.

CONAN: Let's go next to Dennis, Dennis with us from Auburn in California.

DENNIS: Yes, thanks for taking my call, and a very interesting subject. I recently separated from the Army about six months ago. I got out as an NCO, served a tour in Iraq, and I think it's a great program. My concern would be I think it might a little, like, better effective in a larger unit with a wide range of genders and ages. It might be a little harder to implement, say, in a combat infantry company - that's what I served in. It's all male. The focus is more combat operation. I think that probably will be - it can happen there, but that might be a little bit more of a challenge in that atmosphere because there's a lot more of the bravado. You don't want to appear weak. You want to appear like you can keep up with your team. But, I think that there's a need there and it can happen. But it might be a little - I think, one more time maybe to filter down in the combat arms units maybe as averse to units that have a wider range.

But I think it's very possible. And my last point is that I think also the focus really needs to come down to the junior leaders. I mean, the commanders, first sergeants, team sergeants, team leaders, they're busy. The fact that senior specialist, that corporal, that buck sergeant, he's the one that's going to see the behavior on a day to day basis. And eventually, you really going to get to him or her because they'll be able to maybe identify that error. They can tell right away, hey, you know, Private Smith, are you all right? What's going on?

CONAN: Mm-hmm.

DENNIS: Maybe the platoon sergeant is so overwhelmed, that he got so much going on he may not see all those little things happening. But I think it's important to get those junior leaders prepared or at least able to, you know, to implement the program, you'll have more success.

CONAN: All right.

DENNIS: And thanks a lot for taking my call.

CONAN: Thanks very much, Dennis. And General Cornum, we've mentioned this would start in basic training. Would it continue after?

Brig. Gen. CORNUM: Absolutely. There is - the plan is to have not only resilience training and basic training but also in - to continue in a progressive way in the warrior leader course that as our last caller would remember as the PLDC, you know, Primary Leader Development Course, as well as basic noncommissioned officer and the advance noncommissioned officer school.

And we are - we were equally concerned about the possibility that it would be more difficult to implement in the combat arms. And at our last training session in August, with day five of training, and we had a platoon sergeant who was a drill sergeant from the infantry, 11 bravo, who said, on day one I was really skeptical, but now I see that as long as it's somebody like me teaching these skills that this will really be useful.

You know, we have demonstrated already that those guys who - and tough as they are - are in no way immune. And we know that, for example, with the annual or every 18 months mental health advisory teams that we send into Iraq and Afghanistan, we know that those are the people that have the greatest amount of stress symptoms. And, you know, combat is directly related with stress.

Now, there are some things that mitigate that, and good leadership at the lower level is one of the biggest mitigaters we have. But it's still stressful and they are really quite anxious to implement these. And he exactly right. It needs to be at the solider-to-soldier junior leader level.

CONAN: I just want to follow up with this email we got. I've known Rhonda since reporting to Rucker in '87. The Army has done a fantastic job selecting her as the point person for this long overdue training. Best to her, an Army aviator. So, you used to fly helicopters, I take it?

Brig. Gen. CORNUM: Well, I used to. I used to be a flight surgeon at Fort Rucker for a long time when I went to war with the unit in '91, with the unit from Rucker. So I have a long history of - with aviation at Fort Rucker.

CONAN: Brigadier General Rhonda Cornum, also with us Martin Seligman of the University of Pennsylvania.

You're listening to TALK OF THE NATION from NPR News.

And here's an email from Yuric(ph) in Oakland. Dr. Seligman, I'm a positive psychology coach, a huge fan of your work. Our young people are very fortunate to be receiving training from you. My question: is there any data about how this training affects troops' ability to perform tasks and even fight in the field?

Dr. SELIGMAN: No. There is no data about that. And, of course, General Cornum and her research group will be monitoring this very closely. And it is important that it's a positive psychology endeavor. So, what we want to do here is approach our soldiers not through their weaknesses but through strength, not through remediation, but soldiers knowing what their highest strengths are and using them to perform. And in civilian life, there is a good amount of data that when people are approached through strength rather than weakness they do better.

CONAN: Here's another email. This one from Maria. As a former service member and having a husband currently deploying overseas, I know how incredibly unfriendly the military culture can be to any signs of mental or emotional weakness a soldier may show. Therefore, oftentimes, leading to prolonged periods of what appears to be mental strength resilience than a complete mental breakdown, usually post-deployment. How will this program help to transition back into civilian life?

And as I understand it, Brigadier General Cornum, the idea is to help people all the way through.

Brig. Gen. CORNUM: Well, correct. I mean, teaching techniques of looking at difficulties as not catastrophes and as not permanent problems is something that will help you whether you're taking the national boards for EMT licensure or whether you're facing a 15-month deployment. I mean, those are skills, those are mental skills that you'll use regardless of the challenge you face.

CONAN: How long is it going to be, do you think, before you have some objective readings on how well this is working?

Brig. Gen. CORNUM: Well, I think that - I think we actually have some evidence by this fall because we have started a large study, a 54-company study, on resilience training and basic training, which is ongoing as we speak. In terms of deploying this whole program to the Army, I think it will probably be a year, from the end of October, probably next October before I can say with some surety that we're making progress or not.

CONAN: And Martin Seligman, are there any indicators that you would be looking at especially?

Dr. SELIGMAN: Well, we'll be looking at the usual negative indicators like anxiety, depression, post-traumatic stress disorder and suicide. But we're also very interested in the positive indicators: high performance, people doing very well. So, we want to know the whole distribution, the distribution - on the low end is positive stress, post-traumatic stress, the middle resilience and right-hand growth. We want to move the whole distribution toward higher performance and growth. All those things are measurable.

CONAN: And will this be the largest-ever experiment, I guess is not too strong a word to use?

Brig. Gen. CORNUM: Well, we're not describing it as an experiment. We're describing it as training, and I think we have shown that emphasis on physical fitness has resulted in that the Army's average, you know, percent body fat is lower than the civilian society, so I think we will - we have reason to think that unequal emphasis on psychological fitness will result in our psychological fitness being higher than the civilian population in general.

CONAN: Well, General Cornum, thank you so much for your time today. We appreciate it. We know you're busy.

Brig. Gen. CORNUM: Thank you.

CONAN: And General Cornum is the director of Comprehensive Soldier Fitness and joined us from her office in Arlington, Virginia.

Martin Seligman, Chairman of the University of Pennsylvania's Positive Psychology Center, joined us from his home in Philadelphia. Thanks to you, sir.

Dr. SELIGMAN: Thank you, Neal.

CONAN: Up next, eight years after 9/11, what feeling stays with you? What won't let you go? 800-989-8255. Email us: talk@npr.org. Stay with us.

I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

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