By Yochi Dreazen
306 pp. $26
Mark and Carol Graham, an Army couple with two sons and a daughter, lost both sons within a year. Their younger son, Kevin, an ROTC cadet, committed suicide, driven by depression, which may have been the first sign that he was afflicted with familial bipolar affective disorder. Then an IED in Iraq’s Anbar province killed their older son, Jeff, an Army tank lieutenant.
That is a cold recitation of the tragedy that befell a warm-hearted Army family. In “The Invisible Front,” Yochi Dreazen recounts the family’s story with great humanity. The Grahams’ compassion and wisdom as they turned their sorrow into a mission of suicide prevention moved me to tears.
Dreazen, who writes wonderfully, is no innocent when it comes to the U.S. armed services. He is the managing editor of Foreign Policy and has put in years of war reporting for the Wall Street Journal and National Journal, including multiple embeds in the dust and danger of Iraq and Afghanistan. Through articles and now his book, he devotes himself to the mental health issues confronted by our service members and veterans.
In telling the Grahams’ story, Dreazen explores the stigma that attaches to military personnel suffering from mental illness. In Kevin Graham’s case, the young cadet had received treatment for his depression without telling the ROTC or his parents. As the time of his commissioning approached, he stopped taking his antidepressant, fearing that its discovery would abort his Army career. Without treatment, Kevin was again overcome by depression, and his suicide was the result.
As a specialist in the psychological injuries of military veterans, I see spotty progress in combating stigma: For junior enlisted service members with no aspirations for a further military career, help for combat trauma is now more available from direct leaders, chaplains and mental health providers. This slight improvement comes off a very low baseline. The help is not necessarily effective or reliable, but it’s better than it was . Still, many in the military believe that seeking help for mental health issues will be career-ending, and they will not ask for it. Stigma has its own social ecology.
Mark Graham, a retired major general, and his wife, Carol, have campaigned to lift the stigma attached to psychiatric diagnoses, particularly post-traumatic stress disorder. For example, as base commander at Fort Carson, Gen. Graham instituted and — more important — visibly, practically and personally supported an effective suicide hotline on base. But such efforts still have a long way to go. As Dreazen shockingly documents, those who show evidence of PTSD can be subject to open mockery from sergeants who force them, for example, to spend hours in a “dunce’s corner.” Lower-ranking soldiers cast the sufferer out, calling him a “s---bag” to his face, until finally he feels invisible. Unit culture usually arises from the influence of troop leaders, not a base commander such as Graham.
Along with Gen. Peter Chiarelli and others, I have begged the American Psychiatric Association to change the name of the condition from PTS disorder to PTS injury. There is nothing dishonorable in being injured in the service of one’s country, and changing the name would somewhat reduce the stigma. PTSD does not reflect inherent flaws in a soldier; it results from traumatic experience.
As Dreazen shows, the Grahams are helping convince America that psychological injuries from war are honorable war wounds as surely as amputations, gunshots and burns. But changing perceptions will require reversing a culturally inbred notion that underlies the stigma. Many Americans believe that if you emerge from childhood with good genes and good upbringing, then you cannot be harmed behind this bulwark of good character, reason and mental balance. This notion goes back to Plato and runs through the stoics, Kant and Freud. The problem with this idea, despite its brilliant pedigree, is that it’s false. Even the strongest, noblest characters will break under bad enough circumstances — especially when those circumstances are long-standing.