Fighting Stigma in the Military and the Stigma Within
If you have openly discussed your experience of depression, you may well have run into the problem of stigma. Some people I’ve told have been contemptuous, even angry that I “complain” and “whine” about the stresses in life that they say they’ve been able to handle. Others have avoided me altogether, or have treated me as less reliable. But what I found even worse than stigma expressed by other people was the way I stigmatized myself.
When most resilient, I could dismiss people who made offensive and angry remarks as the ones who “just don’t get it.” But when completely down, I’d more likely agree with them and internalize what they said - or what I imagined they thought. When self-esteem has already been shattered by depression, it’s easy to accept the stigma as true, simply confirming what a non-stop inner voice is telling me over and over: you’re not worth much, you’re just a “loser.” And I'd blame myself for not being able to wrap up all the negative feelings in a neat package and toss them in the trash. I believed I should be able to control my emotions completely, and now they were controlling me.
I’ve never served in the military, but a civilian bout with stigma, both external and internal, gives me at least some understanding of the much more intense experience facing soldiers and veterans. Merely Me provided a lot of insight on this issue last year in her interviews with Paul and K.J. From what they have shared, comments by veterans in numerous military blogs, recent studies and press reports, we can get glimpses of what soldiers who have risked so much for the rest of us have been going through to help themselves.
Soldiers are trained to be resilient in combat zones and pride themselves on being able to handle anything, bounce back from any injury and take any risk to help their buddies. Mental focus in the face of unpredictable danger has to be sharp, and emotions, troubles at home or other personal issues have to be pushed aside completely. They face life and death situations every day that most of us will never know.
In that culture, soldiers are often reluctant to report mental health or emotional problems to unit commanders because they’re afraid of damaging their careers and facing contempt from fellow soldiers for being weak. As a result, one of the biggest problems is getting members of the military to take advantage of the care that is available. A study released about two years ago indicated that 300,000 veterans of Iraq and Afghanistan reported symptoms of PTSD and/or depression and that less than half of these were expected to seek treatment from the military health systems.
The campaign to change that is extensive and unprecedented. Its wide publicity, public service announcements, training programs and other resources are not only reaching soldiers but the general public as well. The hope is that the effort will help lessen the fear of stigma and make it easier to get help. It’s backed up by changes of policy designed to end concern that a request for treatment will be formally reported and to allow psychiatrists to treat soldiers without pulling them from active duty as “unfit for combat”.
Despite those changes at the top, the basis for the fear of stigma is the continuing reality of harsh attitudes still encountered every day throughout the services. One sergeant on active duty in Iraq was quoted by the Associated Press last May as confirming that the Army does not regard a soldier’s visit to a counselor as a bad mark. But going to a combat stress center “may be viewed as a weakness by individuals. ... We are alpha males in the infantry.”
A psychiatrist with experience in the Marine Corps reported his frustration at seeing previously strong Marines broken by repeated deployments and then condemned by their commanders as “goddamn losers.” While those attitudes persist, the campaign to fight stigma has seen generals and top sergeants publicly admit their problems with combat stress and PTSD.
You can see an example of this outreach in a powerful video on the Semper Fi Fund site - part of the Marine Corp’s anti-stigma campaign. It features high ranking commanders describing their own emotional problems with combat stress and urging Marines to seek help when they need it, assuring them that they will not be damaging their careers. But other interviews bring out the hardest issues Marines and a lot of the rest of us have to struggle with - the difficulty of facing and expressing emotions and admitting inwardly that something’s wrong.
What comes across so strongly is the way the Marines have learned to discipline and compartmentalize their emotional reactions. It was especially moving for me to listen to one marine talking about the time someone sat her down and told her simply that it was OK to be not OK. That was a revelation. For the first time, she could give herself permission to feel her own reactions of hurt and pain without stigmatizing herself as weak.
Another Marine discussed what he had learned in a new training program about managing stress and reactions to combat.
“I realize basically that it’s OK to have certain emotions. ... It sounds very elementary that I would have to relearn how to use emotions correctly, but that’s kind of what it gets down to. ... It’s OK to be angry, but what do I do now that I am angry? ... or it’s OK to ... show people that I’m happy. Now, how do I do that?”
Emotions become strangers when you believe your survival depends on forgetting that you have them.
Despite the continuing problem of stigma from fellow soldiers, many can find help from a military that’s trying to be more responsive than ever - if they can get past the inner stigma that labels emotional problems as signs of broken strength and failing courage.