Mass Therapy for Depressed Soldiers

Worried about the high rates of depression and suicide, the Army is planning therapy for its 1.1 million soldiers. For many years I have been developing an approach for teaching college students (and my own therapy as well) that may fit the Army's problem exactly. I propose two basic causes of depression: Hidden emotions, and no secure bond with another person. These ideas lead to a practical self/other therapy for depression that might be effective for the Army.

Temporary Lifting of Severe Depression

Many years ago in England, I observed eighty initial interviews of elderly male patients admitted to a mental hospital. They were all deeply depressed in speech and manner. They were mostly outcasts without a secure bond. However, to my surprise, I saw moments in some of the interviews that were like miracles.

The psychiatrists asked about half of the patients about their activity during WWII. For half of these, as they begin to describe their experience during the war, no matter what it was, their behavior and appearance underwent a dramatic change.

Those who changed most sat up, raised their voice to a normal level instead of mumbling, held their head up and looked directly at the psychiatrist. The speed of talk picked up and became clear and coherent. Their facial expressions became lively and showed more color. Each of them seemed like a different, younger, person.

The memory of the patients' earlier acceptance as valued members of their country under attack re-lived the feeling of a secure bond and generated pride. The pride, in turn, counteracted the shame part of their depression. Telling the psychiatrist about belonging to a community had been enough to remove the shame of being outcasts. Each question about WWII was a momentary invention of Positive Psychology.

Many persons have had the experience of community as adults, but have forgotten. These persons, like the patients described above, need only be asked the right questions, or ask them themselves. It would appear that the deficit in these cases is not in the person, but in the social environment. In the rapid pace of modern societies, it is difficult to find a true confidant that is available when needed.

Repression of Emotions and Gender

Boys, more than girls, learn early that vulnerable feelings (love, grief, fear and shame) are seen as signs of weakness. In modern societies most boys learn to hide their vulnerable feelings in emotionless talk, withdrawal, or silence. In situations where this option seems unavailable, one may cover vulnerable feelings behind a display of hostility. Young boys, especially, learn in their families, and later, from their peers, to suppress emotions they actually feel by acting out anger whether they feel it or not.

Vulnerable feelings are first hidden from others, and after many repetitions, even from self. In this latter stage, behavior becomes compulsive. When men face what they construe to be threatening situations, they may be compelled to silence, especially about their emotions.

Even without threat, men seem to be more likely to silence than women. With their partners, most men don't talk freely about feelings of resentment, humiliation, embarrassment, rejection, loss and anxiety, or for that matter, joy, genuine pride and love. They seem to be backed up on a wide variety of intense feelings.

Numbing out fear, particularly, is a catastrophe. Fear is an innate signal of danger that has survival value. When we see a car heading toward us on a collision course, genetic endowment has given us an immediate, automatic fear response: Wake up, your life is in danger! Much faster than thought, this reaction increases our chance of survival; repressing it is dangerous to self and others. Yet most men are trained to equate fear with cowardice. Numbing out fear and other emotions may be the main source of the high rates of depression in the mostly male U. S. Army.

In order to avoid pain inflicted by others, we learn to repress our emotions. After thousands of curtailments, repression becomes habitual and out of consciousness. As we become more backed up with avoided emotions, we have the sense that experiencing them would be unbearably painful. In this way, avoidance leads to avoidance and finally silence in a self-perpetuating feedback loop.

How can our soldiers escape this loop? I have been using exercises to deal with my own bouts of depression and those of my students: Best Moments, Gratitude Letters, and two exercises for finding and connecting with a confidant. I will describe them and their effectiveness in my next blog.