by Jamie Hagen
The U.S. Military’s January 24th lifting of the ban on women soldiers serving in combat is a bittersweet victory for the rights of women. On the sweet side, it offers long-overdue recognition for women who have served in combat zones in Iraq and Afghanistan for many years, and allows them to be eligible for career advancement for their experiences and medals for outstanding service.
On the bitter side, even in war zones, where violence is not unexpected, its disruptive effect on mental health is becoming increasingly clear. The Associated Press reported that as of January 13, “suicides in the U.S. military surged to a record 349 last year, far exceeding American combat deaths in Afghanistan.”
The war experiences of soldiers in Afghanistan and Iraq are different than those in the past because of repeated exposure. Military women and men today serve multiple tours of duty, sometimes as many as seven. For women soldiers exposure to war time violence is complicated by the risk of military sexual trauma (MST) — harassment, assault, and rape — that some say is rampant and very much underreported.
How will the military work to integrate women into their new combat roles? Examining how the military is currently responding to and supporting women reporting military sexual trauma and post-traumatic stress is one way to consider this question.
Post-traumatic stress and the US military
While the military suicide epidemic has led to Veteran Administration initiatives to better serve mental health needs, overall those wounded with psychological trauma take a backseat — even in their own minds — to those with more visually jarring war wounds.
Retired Colonel Jill Chambers, suffered post-traumatic stress after being in the Pentagon during the attack on September 11th. Much of her work focuses on the need for non pharmaceutical therapy to respond to psychological trauma and was recently featured on Makers.com after being awarded a grant to continue her work with vets through her organization This Able Vet.
Chambers view is that in combat zones, “Men and women are experiencing the same thing. There really isn’t a difference. The difference is that nobody ever really expected women to be experiencing these things. It’s been a radical shift in understanding that a nurse or doctor day after day after day seeing the horrors of war is just the same as the guys who are on the front lines shooting.”
Elihu Carrazon, an artist living in Ocean Springs, MS, is a Vietnam veteran diagnosed with post-traumatic stress syndrome (PTSD) who has fought an uphill battle to gain recognition for the longer-term mental health impacts suffered by veterans. “I personally don’t believe that PTSD as related to different military roles is the same in women as compared to men,” said Carrazon. “Women in the military are flanked by abuse and damaging expectations from fellow male soldiers as well as the combined experiences of war-trauma itself.”
Many soldiers are hesitant to report symptoms. Fear of being perceived as weak is a concern for many males and females suffering psychological trauma, magnified by the masculine culture of the military and combat. Considering the social stigma associated with a mental health problem such as PTSD, it’s not hard to understand why military members are hesitant to report their trauma.
According to studies of the general population, women suffer from PTSD at a rate twice that of men. This is attributed to the way women experience trauma and experiences with violent sexual assault.
Retired Colonel Jo B. Rusin, an expert on military leadership and the author of “Move to the Front: A Classic Guide for Women in the Military,” a resource for women leaders in the military. She spoke with me about the different set of rules for American women, explaining that many women are taught to be pretty, be nice, get along, avoid controversy, use sexual charm to get what you want and follow the rules. When faced with abuse, women have a tendency to blame themselves,” said Rusin. But, she continues, “I think in some ways women are set up in our society to get sucked up by guys who are basically bullies. My theory is you need to teach women to stand up and bark.”
Rusin sees it as essential for military leaders to set the tone in responding to sexual harassment and assault.
Anu Bhagwati the Executive Director of the Service Women’s Action Network (SWAN) did just that when she testified before the House Committee on Veteran Affairs in July. Bhagwati explained that military sexual trauma (MST) is the cause of much PTSD in female soldiers and veterans, according to the VA’s own data. And yet some veterans who have suffered what they cynically call the “double whammy” abandon their MST claims and submit a claim only for combat-related PTSD, as they felt their combat claim was more likely to be approved, and that the uphill battle to file an MST claim wasn’t worth the agony,” she said.
Women are often denied claims for post traumatic stress caused by the assault if they did not bring charges at the time. And there are not nearly enough mental-health professionals in the system to help them, according to a TIME magazine story about sexual assault in the military.”
“The sense of betrayal runs deep in victims who joined the military to be part of a loyal team pursuing a larger cause,” explains TIME. “Experts liken the trauma to incest and the particular damage done when assault is inflicted by a member of the military ‘family’.”
The ‘family’ aspect of the military intensifies the experience of abuse. “As a civilian, if you don’t like what’s going on at the office you can usually get away from it because you’re not living with those people 24/7, so if worse comes to worse, you can quit.” explains Rusin. “In the military, you can’t quit. You are stuck working with those people whether your like it or not. The leadership, in my opinion, has a much greater responsibility for the welfare of their troops than any civilian boss.”
The Pentagon estimates a full 80% to 90% of sexual assaults in the US military go unreported.
The investigative documentary “The Invisible War” (2012) about the epidemic of rape of soldiers within the US military reports that women who have been raped or suffered military sexual trauma (MST) had a PTSD rate higher than men who’ve been in combat.
Responding to gender in the modern war zone
SWAN recommends the VA begins to collect gender-specific data on MST claim decisions, develop additional MST-related training and testing on MST claims.
“It is vital that the VA adapt to meet the needs of the increasing numbers of female veterans,” writes Lily Roberts of the Roosevelt Institute, a New York-based progressive nonprofit organization. “While VA services in recent years have increased their emphasis on mental health, logistical aspects of many hospitals can make accessing care challenging for patients, particularly for women. An important example is that women may be barred from group therapy sessions dealing with issues of PTSD because spots are reserved for those who saw combat. Even female veterans decorated for their performance in combat may be prohibited from group therapy for this reason.
In December 2012 the Senate passed Senator Patty Murray’s (D-Wash) chairwoman of the Senate Veterans Affairs Committee amendment pushing to hire combat veterans for peer-to-peer counseling and streamline the sharing of records between the Defense Department and the Department of Veterans Affairs. The House and Senate must still negotiate the amendment before it will be implemented. In addition to these changes, the Murray amendment would compel each military service to adopt common practices in behavioral health and suicide prevention programs. The Senate also passed a bill allowing expanding insurance coverage for military women seeking abortion. At present, even in the case of rape and incest insurance does not cover abortion for women in the armed forces.
Military Leadership Setting the Tone
Preventing assault begins with leadership, according to Rusin. “The leaders on the team have to acknowledge the women on the team are just as important as the men on the team” This approach worked for mitigating racial inequality in the armed forced. Senior leadership put their foot down on discrimination and cheap shots about minorities. The tone from the top was very important in making the change.
More gender research about the military experience in Afghanistan and Iraq is required to better understand the impact of combat zones on the mental health of women veterans. As reports of sexual assault and the military suicide stats continue to rise, again and again the pitfalls of a short-sided social service support network takes a tragic toll on returning veterans.
According to Rusin: “One of the dynamics going on in the military right now is that people are very concerned with looking bad as a leader or making their boss look bad as a leader so they don’t want to address something that will come out in a real nasty PR mess that reflects on them….They will do almost anything to bury it. The tone from the top is there, but it’s getting diluted.”
Approaching sexual assault as simply a PR problem can mean more energy is spent on covering it up and making sure cases are not reported, than on helping women who have been traumatized and preventing the problem to begin with. For this, the military and indeed all of us need to view women soldiers as a precious resource and make every effort to help them do their jobs well, recognize their contributions, and emerge from their tours of duty healthy and strong enough to continue contributing (and enjoying) civilian life.