Taking the anxiety out of combat

You can train soldiers to be fit for the physical demands of battle, but can you also train them to be “psychologically fit”? Controversially, the American military has decided that you can.

For the past two years the US Armed Forces has been first piloting and then rolling out across the US Army a radical $150 million programme called “Comprehensive Soldier Fitness”.

It aims to assess the emotional and spiritual resilience of soldiers and also to offer them remedial training if they are lacking it. The programme even tries to provide “post-traumatic growth” for those who have already experienced significant adverse experience in combat.

For hard-bitten drill sergeants of the US Army the programme has unexpected consequences. Each month 180 are sent for so called “Master Resilience Training”.

“Skills learnt include emotion awareness and regulation, impulse control, de-catastrophising, putting it in perspective, effective communication, challenging negative beliefs, problem solving, and real-time resilience,” promises one course at Fort Jackson, South Carolina.

Dr Martin Seligman is one of the US’s pre-eminent psychiatrists and the man whose advice, given to the military on a pro bono basis, is the foundation for the programme. He acknowledges that combat veterans might be expected to regard such training as “girly psychobabble”. But he claims the courses have been hugely popular.

The rationale behind the programme is simple. Health studies indicate that 12-20 per cent of US veterans of the wars in Iraq and Afghanistan are suffering post-traumatic stress including chronic depression and anxiety. In such cases, a ptsd test might assist in determining whether an individual is experiencing symptoms of post-traumatic stress (PTSD).

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US commanders acknowledge that their duty of care to war veterans is likely to translate into billions of dollars in health costs over the coming decades. US generals leapt at the idea of a preventative approach.

A key element of the programme is the annual 105-question Global Assessment Tool (GAT). Taken so far by 1.1 million servicemen, it is the largest psychological profiling exercise in history. The questions are designed to measure the subjects’ emotional, family, social and even spiritual wellbeing. The US military says that results are data-protected and seen only by the subject. Those deemed to be insufficiently “fit” are then prescribed online remedial courses.

Dr Seligman has written several books on “positive psychology” and was invited to 10 Downing St this month to discuss some of his ideas of offering similar training to British schoolchildren.He says that the information culled from the army test results have produced startling insights.

For instance, there is “robust evidence” to correlate particular patterns of answers in their GATs to the 83 US soldiers who committed suicide last year. Last year’s GAT tests for soldiers convicted of drug-taking and crime also displayed some particular patterns of answers. Conversely there were measurable correlations to the answers of the 33 colonels selected from among 1,200 for early promotion to brigadier last year. Might such a programme be used by British forces? Dr Seligman says there has been no interest so far.

It would be dangerous to oversimplify the US programme results, says Professor Simon Wessely, Chief Psychiatrist to the British Army. “I would be doubtful Dr Seligman has stumbled on the holy grail of individual predictions,” he told The Times. “The variables are all individually rather weak. It is not sensitive or specific enough to make individual predictions.”

Professor Wessely points to an attempt to screen out psychologically weak volunteers by the US Air Force during the Second World War. When the policy was reversed and the rejected candidates were allowed to join, they had twice the rate of psychological problems compared to their peers, but 80 per cent still served without problems. That 80 per cent had previously been stigmatised by their rejection.

Post-traumatic stress problems are as much to do with the particular incidents endured as to the pre-existing psychology of the individual, he claims.

He also points out that British veterans of Iraq and Afghanistan have a much lower incidence of PTSD (around 4 per cent) than US forces, who serve 12-15month tours with a year-long break, compared to the British six months with 18 months between tours.