AL HILLAH, Iraq -- A very real battle is just beginning for some troops as they learn to cope with the memories of the carnage of war and the stress of keeping the peace in Iraq.
Just as armor and gun ships were deployed to support the infantry moving to Baghdad, the military has been mobilizing forces to help the war fighters come to terms with the physical and psychological effects of war.
To keep stress from overwhelming the troops, chaplains, along with teams of counselors, psychiatrists, medics and hospital corpsmen travel with the war fighters to ensure that the effect of battle stress are dealt with early, before it becomes a long-term problem.
Although the combat phase is over, battle stress can still degrade operations, said Navy Capt. Robert Koffman, the Navy's senior combat stress consultant during a recent brief to Marine leaders.
Peacekeeping operations are stressful to warriors. Situations such as witnessing the horrors of mass gravesites, or trying to help civilians who are hostile to the military, can be just as detrimental to mental health as combat, he said.
In a war, a soldier or Marine knows that he must destroy his enemy. In nation-building or peacekeeping operations, objectives are not all that clear.
"Even though we no longer have to wear our gas masks you can still see people who refuse to take off their gas masks or make a point to know where the closest scud bunker is," said Navy Lt. Cmdr. Jeffery T. Han, a Chaplain assigned to the First Marine Expeditionary Force, which was deployed to support Operation Iraqi Freedom. "Battle stress caused from anticipating the fight can be as damaging as the actual fight."
Combat stress has been called many things. During World War One it was described as shell shock, and during the World War II it was known as battle fatigue. Whatever name, battle stress can be problematic to a unit's ability to fight.
The number of service men and women killed in combat in Vietnam was equal to the number who committed suicide, according to statistics provided by Koffman.
Battle stress isn't a sign of insanity, experts insist. According to Han, there shouldn't be any stigma associated with individual treatment for battle stress. The focus rather is acknowledging the feelings are real and need to be dealt with, he said.
"The problem is that you have to treat them just like everybody else," said Petty Officer 2nd Class Juan Carlos E. Montgomery, a psychiatric technician working with I MEF at Camp Commando, Kuwait. "If you treat them differently or give them an easier work load, you are going to cause a bigger problem than what they had."
"It can cause more long-term problems for the Marines if we take them off the line," Montgomery continued. "You have to understand that battle stress is not a psychological problem but a very normal reaction to an abnormal situation."
Although stress is normal, dealing with it early keeps it from developing into a psychological disorder, such as Post-Traumatic Stress Disorder, which came to light in the treatment of Vietnam veterans.
Treating battle stress is something that is not only dealt with in the military, civilians whose occupations expose them to traumatic events sometimes experience similar reaction. Civilian experts use many of the same remedies the military uses to keep those professionals on the job.
"I call it killing our own," said Dr Nick Marzella PhD, a psychologist from Columbus, Ohio who specializes in counseling police officers and fire fighters who have been involved in traumatic incidents. He served as an Army counselor during the Viet Nam war.
"We have a tendency to second guess how people respond in critical incidents," he said. "It is a self-defense mechanism to make us feel better, as though we would have done things differently."
Marzella explained that he when he teaches police departments how to support officers who survive a critical incident that has just one simple rule.
"Just tell them that they did a good job," said Marzella. "If he survives the altercation, he did a good job."
To guard against battle stress, unit members and leaders need to be alert to any signs that someone may become affected by battle stress.
"It is a leadership thing," Montgomery said. "If you have a super troop and all of the sudden he is withdrawing from others, or not taking care of hygiene, you are going to have a problem."
One of the most effective ways to help troops cope with stress is listening to them. The more a person can talk about his experiences the easier it will be for him to cope with his experiences, explained Montgomery.
Marzella trains police officers who have survived traumatic incidents to work with other officers who have experienced critical incidents such as shootings or witnessing horrific crime scenes.
Talking with someone who has been through similar experiences can ease the feeling of guilt and confusion that can accompany surviving a traumatic event.
Although troops may be able to get out of a country without any symptoms of battle stress, they still need to be aware of potential problems once they get back home. It is not unusual to experience symptoms of battle stress six months to a year after experiencing traumatic incidents, according to Han.
Han is worried about servicemembers after they get home. While the Marines are focusing on rebuilding Iraq, he is focusing on developing a plan to help the Marines cope with unsettling feelings and emotions after they get back.
Upon returning home it home it will not be unusual for soldiers, sailors and Marines to feel withdrawn, or anxious. The warrior's families may even bear the brunt of tirades of anger that seem to come out of nowhere. Even reoccurring nightmares or changes in sleep patterns may point to potential problems. The problem will only be a problem if after the troop returns home he or she does not seek help.
" These feelings are signs that you are a normal, that you are a strong person who has gone through a horrific event in your life," said Han. "The worst thing you can do is ignore it in yourself or your buddy."