Tending to the Psychic Wounds of POWs

Captured in the Iraqi desert after a surface-to-air missile downed the F-15E he was piloting in the 1991 Gulf War, Col. David Eberly was isolated, brutally interrogated and nearly starved. He had shrapnel wounds to the face and neck, suffered intestinal disease and lost a third of his body weight. It was a nightmare he will never forget.

What he doesn't recall clearly is how a crack team of military psychologists began repairing his fragile state of mind after his return to U.S. forces.

"I was physically and mentally exhausted," says the retired Air Force colonel, who lives in Williamsburg. "But I guess it was helpful 'cause I haven't gone nuts."

In military psych-speak, the mental-healing process Eberly underwent 12 years ago is called "decompression." Pfc. Jessica Lynch, the most heralded POW in the current fighting in Iraq, has been decompressing since her dramatic rescue April 1. So will the remaining American POWs once they are repatriated.

"The mission is, we're not going to leave anybody behind" -- and that includes body and mind, says Col. Bob Roland, an Army clinical psychologist at the National Defense University at Fort McNair. "The sooner we get to them and help them put things into context, the less possibility of negative long-term effects."

The military defines decompression as "the process of normalizing psycho-physiological and behavioral adjustments that individuals made in order to cope" with hostile captivity, isolation, degradation, beating and torture. In other words, to survive that extreme traumatic and pathogenic ordeal, POWs often must engage in abnormal mental states and skills from which they need to be eased back to normality.

"It can be a pretty rough experience," says Bethesda psychologist Charles H. Stenger, a consultant to the American Ex-Prisoner of War Association. "You are under the total control of somebody who doesn't give a damn whether you live or die."

He knows firsthand. A combat medic with the Army's 106th Infantry Division in World War II, he was captured at the Battle of the Bulge and spent six months in a Nazi slave-labor camp.

"You are totally vulnerable and helpless," he says. "Whether you are there a few minutes or a few days, anything that made any sense to you in your life is no longer relevant."

Yet POWs in WWII were set loose to fend for themselves without therapeutic help, says Stenger. "You simply were deloused, provided clean clothes and fed. Other than that, nothing." The current process, he says, recognizes the need "to give these individuals emotional support while they are regrouping themselves."

Since the Vietnam War, the U.S. armed forces have developed by-the-book procedures designed by military psychologists and psychiatrists who, as of 1999, are assigned to the Joint Personnel Recovery Agency under the Joint Forces Command, headquartered at Fort Belvoir. Part of JPRA's mission is coordinate POW recovery and reintegration -- from the moment a soldier is taken back until he is taken home. Even afterward.

In current military operations, when a POW is recovered, combat psychologists trained in the Joint Forces Command's SERE program (Survival, Evasion, Resistance and Escape) meet him or her at the helicopter ramp along with medical doctors and intelligence specialists. This "repatriation team" immediately begins assessing the POW's medical and mental condition -- sizing up factors such as weight loss, muscle loss, hair loss, depression and disorientation. And they start talking -- talk therapy.

"The therapy is designed to allow him or her to come to grips," says POW historian Robert C. Doyle, author of "Voices From Captivity: Interpreting the American POW Narrative" and "A Prisoner's Duty: Great Escapes in U.S. Military History."

The job of the psychologists is to talk the POW through the tricky emotional quagmire that can include symptoms such as euphoria, survivor guilt, depersonalization, even liberation anxiety. Doyle coined the term "lament" for the overall emotional impact.

"Every POW from every war in the 20th century bears some kind of guilt with the experience," says Doyle. "They grieve for what was lost -- time, buddies killed or lost, sometimes lost opportunities and careers, marriages gone amok."

Decompression continues up to four hours a day after the POW is moved to Landstuhl Regional Medical Center, the U.S. military hospital in Germany. And serious debriefings begin. Intelligence specialists focus on critical strategic details about the enemy, its capture and treatment of the POW, and how the POW handled himself, what mistakes were made and why.

Roland says debriefing isn't an official inquiry as much as it is a recounting of events. A psychologist is present to make sure the POW isn't overtaxed.

"It helps people relay what has happened to them in a way that makes sense and put it into perspective. You can imagine how jumbled these things get for the POW," says Roland, who has been communicating with the psychologists decompressing Lynch at Landstuhl. "But if they can get four good days with the POW, they can do miraculous work that, if they don't do upfront, can take years."

Typically, the POW's first concern is over the fate of the soldiers he serves with. His second is about how he performed: "When you're taking them out on a stretcher," says Roland, "they're saying, 'How's Charlie? Did Joe get out?' And then it's 'Did I comport myself in a way that is honorable?' "

The low point psychologically in the military's handling of its POWs came in the Korean War when 21 U.S. POWs, under the influence of the Chinese, refused repatriation and defected to China. Debriefings became hostile investigations in search of possible disloyalty or collaboration with the enemy. "The U.S. Army went ballistic and began to believe that the POW was a security risk," says Doyle.

In 1955 President Eisenhower signed the first military Code of Conduct, then called the "Fighting Man's Code." It spelled out a soldier's duty if taken prisoner -- no collaboration with the enemy, give only name, rank and serial number, resist the enemy, and so forth. This gave POWs guidance in the Vietnam War, even as the military psychologists were still just learning how to handle returning POWs.

"The very people who did the tactical intelligence debriefing in Vietnam said we have to add another whole level to this," says Roland. "They said we have to integrate psychological debriefing into our process to not only get better information but to look out for the long-term mental health of the individual."

Psychological support evolved into a military science. Now debriefers give POWs a "report card" on how they fared in terms of the Code of Conduct. They reassure them they survived with honor and defuse thoughts of being "a loser" for being captured -- "the most unbearable" of all degrading POW emotions, says Doyle.

Not all cases are alike. Some POWs suffer long-term symptoms and post-traumatic stress disorder; others rejoice to be free and quickly put their ordeal behind them.

"There wasn't much to it," says Col. Rhonda Cornum, an Army surgeon captured by Iraqi troops during Operation Desert Storm in 1991 after her helicopter was shot down.

During eight days of captivity, suffering two broken arms, smashed knees and a gunshot wound to the shoulder, she was sexually assaulted once and interrogated repeatedly.

When military psychologists began her decompression, she was ready to go home: "I asked them, 'You think I have some kind of problem?' And they said no. And I said, 'Who-ah, I'm out of here.' I just came home and went back to my normal life."

Currently studying at the National War College here, Cornum takes command at Landstuhl this summer. "I think it's a great thing that they have a program for people who need it," she says.

Before the POW leaves Landstuhl for home, the repatriation team devises a plan for dealing with family, the media, and all the other demands a POW will face in the United States.

"They will work with the family and the individual for one year of post-release, and maybe longer," says Roland. "Sometimes people recover memories after the episode is over just sitting under a tree in West Virginia. We're going to have people available if that happens."

That's been happening to Daniel Stamaris lately. A staff sergeant during the 1991 Gulf War, Stamaris fell into Iraqi hands when his Chinook helicopter crashed on a search-and-rescue mission near Basra. His leg, pelvis and ribs broken, his captors beat and threatened him for seven days. They left him in the desert to die -- twice.

Today Stamaris, who lives in Headland, Ala., says, "Things bother me sometimes." The current fighting in Iraq has made suppressed memories resurface. "Sometimes things just pop in your head."

Stamaris occasionally still talks to a Veterans Administration psychologist, but since 1996 hasn't gone to the annual voluntary follow-up therapy for POWs at the Navy's Robert E. Mitchell Center for Prisoner of War Studies in Pensacola, Fla. He thinks he might try to make the next one. "Just talking about it, just letting it come out, helps," he says.

Eberly, who wrote about his POW survival in his book "Faith Beyond Belief: A Journey to Freedom," says the yearly trip to Pensacola has been valuable.

"We meet for an hour or two with the head shrink and talk about how things are going," says Eberly. "It's not intrusive. It has allowed us a transition to carry on our careers and lives. I think the POW process has gotten better and better."

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