Fallujah assault still exacting heavy toll on mental health of US marines

NEAR FALLUJAH, Iraq (AFP) - Nearly six weeks after US marines stormed the rebel enclave of Fallujah, military psychologists are still seeing a steady stream of service personnel traumatised by the long days and nights of ferocious street fighting.

In the macho culture of the US Marine Corps, it is sometimes hard for its personnel, male or female, to admit they have a problem and some try to ride out the symptoms, only seeking help after weeks of suffering in silence.

The warning signs can range from irritability to extreme apathy, says Lieutenant Erryn Simmons, a trained psychologist who runs a combat stress management unit in this US base just outside the western Iraqi city.

Her colleague Lieutenant Thomas Fearing nods in agreement. "They are coming to us predominantly for sleep-related problems, such as insomnia or nightmares, bad dreams," he says.

"After the offensive began, we had a lot of patients, then there was this lull, and it has picked up again recently with people trying to sit on their symptoms."

The marines lost more than 50 dead and hundreds wounded, some of them seriously, in the huge assault launched on November 8, the largest since last year's invasion.

The US-backed government put rebel losses at more than 2,000, although unit commanders later revealed their troops had orders to shoot all males of fighting age seen on the streets, armed or unarmed, and ruined homes across the city attest to a strategy of overwhelming force.

The marines who seek help can be haunted by the sight of appalling injuries, the screams of wounded comrades, the fear of death, or simply the chaotic hell of combat, the psychologists say.

"We get mostly enlisted men, because they represent the bulk of our troops, but we also get a few NCOs and officers," says Simmons.

"We are here to prevent the combat stress symptoms from turning into post-combat syndrome disorder," she says.

"One technique is the listening experience, where we try to make them realise what really happened, how it happened, and why they display symptoms of stress because of this.

"We also have relaxation strategies or we can use sleep medication."

Fearing says most of those seeking help have been treated successfully through counselling, although one or two have needed more intensive therapy.

"All went back to duty, except for a few worst cases... we had a couple of them staying a few days with us," he says.

Given the difficulties of getting marines to seek help in the first place, it is perhaps understandable that the corps's press officers refused AFP's requests to interview some of the servicemen and women who were receiving treatment.

The marines were the last of the services in the US military to acknowledge that the stresses of the combat could undermine its fighting capacity and to recruit psychologists to provide counselling and other therapies.

"You are talking about a very macho, masculine environment, where there is a stigma attached to looking weak or in fear," says Simmons, one of a growing number of women in the corps.

"But I guess there's been a real shift to admit that somebody suffering from combat stress is not necessarily deranged or crazy."

At the moment the unit is treating five or six patients a day. Most return to active duty after a short series of 45-minute counselling sessions.

Simmons says that oddly it is more effective to treat traumatised personnel within their units rather than sending them home to families, who can often struggle to understand what their loved ones have been through.

"It's better if we can keep them with us, because we can provide support," she says.

"Maybe, it's better for them than to be sent back home, because, for some, their stronger family is here not there."

Posted: Saturday December 18,2004 - 09:47:00 am
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