Chapter 8

Turning Trauma into Growth

“That is a big idea, Dr. Seligman,” said General David Petraeus, “producing more post-traumatic growth rather than just focusing on post-traumatic stress disorder, and approaching training through our soldiers’ strengths rather than drilling their weaknesses out of them.” I had just briefed the twelve four-star generals led by General Casey about resilience training and the effect it should have on a soldier’s reaction to combat.

So let’s get literate about post-traumatic stress disorder. This will illuminate one of the basic rationales for Comprehensive Soldier Fitness and will explain what I meant when I told the four-stars that focusing on PTSD was the tail wagging the dog.

Post-Traumatic Stress Disorder

Shell shock and combat fatigue were psychiatric diagnoses from World War I and World War II. But modern thinking about the psychological damage caused by combat begins not in a war but with a flood. In the early morning of February 26, 1972, the dam on Buffalo Creek in the coal region of West Virginia collapsed, and within a few seconds, 132 million gallons of sludge-filled black water roared down upon the residents of the Appalachian mountain hollows below. Kai Erikson, son of the famed psychologist Erik Erikson, wrote a landmark book about this disaster. Everything in Its Path, published in 1976, marks the inflection point for thinking about trauma. In it, Erikson articulates what would soon become the criteria for diagnosing PTSD in the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual, and was to be liberally (some say “promiscuously”) and immediately applied to veterans of the Vietnam War. Listen to the survivors of Buffalo Creek, as chronicled by the younger Erikson.

Wilbur, his wife, Deborah, and their four children managed to survive.

For some reason, I opened the inside door and looked up the road—and there it came. Just a big black cloud. It looked like twelve or fifteen foot of water …

Well, my neighbor’s house was coming right up to where we live, coming down the creek … It was coming slow, but my wife was still asleep with the baby—she was about seven years old at the time—and the other kids were still asleep upstairs. I screamed for my wife in a bad tone of voice so I could get her attention real quick … I don’t know how she got the girls downstairs so fast, but she run up there in her sliptail and she got the children out of bed and downstairs …

We headed up the road … My wife and some of the children went up between the gons [railway gondolas]; me and my baby went under them because we didn’t have much time … I looked around and our house was done gone. It didn’t wash plumb away. It washed down about four or five house lots from where it was setting tore all to pieces.

Two years after the disaster, Wilbur and Deborah describe their psychological scars, the defining symptoms of a post-traumatic stress disorder. First, Wilbur relives the trauma repeatedly in his dreams:

What I went through on Buffalo Creek is the cause of my problem. The whole thing happens over to me even in my dreams, when I retire for the night. In my dreams, I run from water all the time, all the time. The whole thing just happens over and over again in my dreams …

Second, Wilbur and Deborah have become numb psychologically. Affect is blunted, and they are emotionally anesthetized to the sorrows and joys of the world around them. Wilbur says:

I didn’t even go to the cemetery when my father died [about a year after the flood]. It didn’t dawn on me that he was gone forever. And those people that dies around me now, it don’t bother me like it did before the disaster … It just didn’t bother me that my dad was dead and never would be back. I don’t have the feeling I used to have about something like death. It just don’t affect me like it used to.

And Deborah says:

I’m neglecting my children. I’ve just completely quit cooking. I don’t do no housework. I just won’t do nothing. Can’t sleep. Can’t eat. I just want to take me a lot of pills and just go to bed and go to sleep and not wake up. I enjoyed my home and my family, but outside of them, to me, everything else in life that I had any interest in is destroyed. I loved to cook. I loved to sew. I loved to keep house. I was all the time working and making improvements on my home. But now I’ve just got to the point where it don’t mean a thing in the world to me. I haven’t cooked a hot meal and put it on the table for my children in almost three weeks.

Third, Wilbur experiences symptoms of anxiety, including hyperalertness and phobic reactions to events that remind him of the flood, such as rain and impending bad weather:

I listen to the news, and if there is a storm warning out, why, I don’t go to bed that night. I sit up. I tell my wife, “Don’t undress our little girls; just let them lay down like they are and go to bed and go to sleep and then if I see anything going to happen, I’ll wake you in plenty of time to get you out of the house.” I don’t go to bed. I stay up.

My nerves is a problem. Every time it rains, every time it storms, I just can’t take it. I walk the floor. I get so nervous I break out in a rash. I am taking shots for it now …

Wilbur also suffers from survival guilt:

At that time, why, I heard somebody holler at me, and I  looked around and saw Mrs. Constable … She had a little baby in her arms, and she was hollering, “Hey, Wilbur, come and help me; if you can’t help me, come get my baby”… But I didn’t give it a thought to go back and help her. I blame myself a whole lot for that yet. She had her baby in her arms and looked as though she were going to throw it to me. Well, I never thought to go help that lady. I was thinking about my own family. They all six got drowned in that house. She was standing in water up to her waist, and they all got drownded.

These symptoms were officially ratified into a disorder in 1980 in the third edition of the DSM. Here from the fourth edition are the latest criteria for diagnosing a case of PTSD:

— 309.81 DSM-IV Criteria for Post-traumatic Stress Disorder —

A. The person has been exposed to a traumatic event.

B. The traumatic event is persistently reexperienced.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness.

D. Persistent symptoms of increased arousal.

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

An important qualifier, more honored in the breech, is that the symptoms must not be present before the trauma.

PTSD started to make its debut toward the end of the Vietnam War and was widely applied immediately. Here is a composite case of PTSD from the Iraq War.

Mr. K, a 38-year-old National Guard soldier, was assessed in an outpatient psychiatric clinic several months after he returned home from a 12-month deployment to the Sunni Triangle in Iraq, where he had his first exposure to combat in his 10 years of National Guard duty. Before deployment, he worked successfully as an automobile salesman, was a happily married father with children ages 10 and 12 years, and was socially outgoing with a large circle of friends and was active in civic and church activities. While in Iraq, he had extensive combat exposure. His platoon was heavily shelled and was ambushed on many occasions, often resulting in death or injury to his buddies. He was a passenger on patrols and convoys in which roadside bombs destroyed vehicles and wounded or killed people with whom he had become close. He was aware that he had killed a number of enemy combatants, and he feared that he may also have been responsible for the deaths of civilian bystanders. He blamed himself for being unable to prevent the death of his best friend, who was shot by a sniper. When asked about the worst moment during his deployment, he readily stated that it occurred when he was unable to intercede, but only to watch helplessly, while a small group of Iraqi women and children were killed in the crossfire during a particularly bloody assault.

Since returning home, he has been anxious, irritable, and on edge most of the time. He has become preoccupied with concerns about the personal safety of his family, keeping a loaded 9-mm pistol with him at all times and under his pillow at night. Sleep has been difficult, and when sleep occurs, it has often been interrupted by vivid nightmares during which he thrashes about, kicks his wife, or jumps out of bed to turn on the lights. His children complained that he has become so overprotective that he will not let them out of his sight. His wife reported that he has been emotionally distant since his return. She also believed that driving the car had become dangerous when he is a passenger because he has sometimes reached over suddenly to grab the steering wheel because he thinks he has seen a roadside bomb. His friends have wearied of inviting him to social gatherings because he has consistently turned down all invitations to get together. His employer, who has patiently supported him, has reported that his work has suffered dramatically, that he seems preoccupied with his own thoughts and irritable with customers, that he often makes mistakes, and that he has not functioned effectively at the automobile dealership where he was previously a top salesman. Mr. K acknowledged that he has changed since his deployment. He reported that he sometimes experiences strong surges of fear, panic, guilt, and despair and that at other times he has felt emotionally dead, unable to return the love and warmth of family and friends. Life has become a terrible burden. Although he has not been actively suicidal, he reported that he sometimes thinks everyone would be better off if he had not survived his tour in Iraq.

The diagnosis has been a staple of the U.S. Medical Corps throughout the present Iraq and Afghanistan wars, with as many as 20 percent of the soldiers said to be afflicted, and this is exactly what had brought me the invitation to lunch with the generals.

I told the generals that there is a bell-shaped distribution of the human response to high adversity. At the extremely vulnerable end, the result is pathology: depression, anxiety, substance abuse, suicide, and what had now found its way into the official diagnostic manual as PTSD. Every soldier going to Iraq or Afghanistan has heard of PTSD. But the human species has evolved through millennia of trauma, and far and away the usual response to high adversity is resilience—a relatively brief episode of depression plus anxiety, followed by a return to the previous level of functioning.

At West Point, we found that more than 90 percent of cadets had heard of post-traumatic stress disorder, which in reality is relatively uncommon, but less than 10 percent had heard of post-traumatic growth, which is not uncommon. This is medical illiteracy that matters. If all a soldier knows about is PTSD, and not about resilience and growth, it creates a self-fulfilling downward spiral. Your buddy was killed yesterday in Afghanistan. Today you burst into tears, and you think, I’m falling apart; I’ve got PTSD; my life is ruined. These thoughts increase the symptoms of anxiety and depression—indeed, PTSD is a particularly nasty combination of anxiety and depression—which in turn increases the intensity of the symptoms. Merely knowing that bursting into tears is not a symptom of PTSD but a symptom of normal grief and mourning, usually followed by resilience, helps to put the brakes on the downward spiral.

Post-traumatic stress disorder surely increases in likelihood because of the self-fulfilling nature of the downward spiral that catastrophizing and believing you have PTSD engenders. Individuals who are catastrophizers to begin with are much more susceptible to PTSD. One study followed 5,410 soldiers through their army careers from 2002 to 2006. Over this five-year period, 395 were diagnosed with PTSD. More than half of them were in the bottom 15 percent of mental and physical health to begin with. This is most reliable—and one of the least quoted—facts in the entire PTSD literature: the people who are in bad shape to begin with are at much greater risk for PTSD than more psychologically fit people, and PTSD can often better be seen as an exacerbation of preexisting symptoms of anxiety and depression than as a first case. It is just these findings that underpin one rationale for the resilience training in CSF (below): by strengthening our soldiers psychologically before combat, we can prevent some cases of PTSD.

Here I must assume a curmudgeonly voice. The residents were suing the Pittston Company, the owners of the dam, for more than $1 billion. In my opinion, that kind of money can lead to exaggerated and prolonged symptoms even though the literature suggests that the survivors were not malingering. They won the lawsuit eventually, so we will never know what effect the financial incentive had. A parallel system is at work in military PTSD, unfortunately. A diagnosis of full-blown PTSD will earn a veteran a disability payment of around $3,000 a month for the rest of his life. Becoming gainfully employed or experiencing remission of the symptoms ends the reimbursement. Once veterans get the diagnosis and the disability payments begin, 82 percent do not return for therapy. We do not know what effect this substantial incentive is having on the diagnosis of PTSD from our wars, but the 20 percent rate often reported from Iraq and Afghanistan is way above the rates in previous wars or the rates shown in other armies that do not reimburse PTSD as a disability. British soldiers returning from Iraq and Afghanistan have a PTSD rate of 4 percent. I have combed the Civil War writings and can find almost no PTSD or anything much like it from that horrific epoch.

Skepticism aside, I want to say clearly that I am sure there is a core PTSD. I do not believe that PTSD is malingering. My doubts are about overdiagnosis. I believe that our society owes much more than we now give to our returning veterans by way of gratitude and by way of money. I do not believe, however, that the gratitude should come by way of a disability diagnosis and a system that robs our veterans of their pride.

Post-Traumatic Growth

Never to be forgotten, finally, is post-traumatic growth (PTG). A substantial number of people also show intense depression and anxiety after extreme adversity, often to the level of PTSD, but then they grow. In the long run, they arrive at a higher level of psychological functioning than before. “What does not kill me makes me stronger,” said Nietzsche. Those old soldiers who populate Veterans of Foreign Wars posts and tell war stories are not in denial—war was indeed the best time of their lives.

A few years ago, Chris Peterson, Nansook Park, and I added a link to my Authentic Happiness website www.authentichappiness.org. The new questionnaire listed the fifteen worst things that can happen in a person’s life: torture, grave illness, death of a child, rape, imprisonment, and so on. In a month, 1,700 people reported at least one of these awful events, and they took our well-being tests as well. To our surprise, individuals who’d experienced one awful event had more intense strengths (and therefore higher well-being) than individuals who had none. Individuals who’d been through two awful events were stronger than individuals who had one, and individuals who had three—raped, tortured, and held captive for example—were stronger than those who had two.

 

Brigadier General Rhonda Cornum is a poster child for post-traumatic growth. I had read about Rhonda back in 1991 when she was a major and a prisoner of war of Saddam Hussein’s army. Cornum—MD urologist, PhD biochemist, flight surgeon, jet pilot, civilian helicopter pilot—was on a rescue mission over the Iraqi desert when her helicopter was hit by enemy fire. As it went down, the tail boom was blown off, and all but three of the eight-person crew were killed.

Rhonda, both arms and a leg broken, was taken prisoner. She was sexually assaulted and brutally treated. Released eight days later, she came back a war hero. She describes the aftereffects of her traumatic experience:

 

• Relating to patients: “I felt much better prepared to be a military physician and surgeon than previously. The concerns of my patients were no longer academic.”

• Personal strength: “I felt far better equipped to be a leader and commander. That is the standard by which other experiences are now based, and so I feel much less anxiety or fear when faced with challenges.”

• Appreciation of family: “I became a better, more attentive parent and spouse. I made the effort to remember birthdays, to visit grandparents, and so on. No doubt, coming that close to losing them made me appreciate them more.”

• Spiritual change: “An out-of-body experience changed my perceptions; I was now open to at least the possibility of a spiritual life versus a physical life.”

• Priorities: “While I had always organized my life into the A, B, and C piles of priority, I became much more rigorous about dispensing with the C pile. (I always go to my daughter’s soccer games!)”

 

After she was freed, a colonel said to her, “It’s too bad you are a woman, Major, otherwise you could be a general.” I have since seen the legend personally: when she walked into a cavernous auditorium where we were both speaking in August 2009, 1,200 majors and colonels rose to their feet and applauded. As the general in charge of CSF, Rhonda takes more than a detached professional interest in the PTG module.

Post-Traumatic Growth Course

She recruited two professors of psychology to oversee the PTG module: Richard Tedeschi, the academic leader of the PTG field, from the University of North Carolina at Charlotte, and Harvard’s Richard McNally. The module begins with the ancient wisdom that personal transformation is characterized by renewed appreciation of being alive, enhanced personal strength, acting on new possibilities, improved relationships, and spiritual deepening, all of which often follow tragedy. Data support this: in just one example, 61.1 percent of imprisoned airmen tortured for years by the North Vietnamese said that they had benefited psychologically from their ordeal. What’s more, the more severe their treatment, the greater the post-traumatic growth. This is not remotely to suggest that we celebrate trauma itself; rather we should make the most of the fact that trauma often sets the stage for growth, and we must teach our soldiers about the conditions under which such growth is most likely to happen.

Post-Traumatic Growth Inventory

Dr. Tedeschi uses the Post-Traumatic Growth Inventory (PTGI) to measure the phenomenon. Here are some sample items:

0 = I did not experience this change as a result of my crisis.

1 = I experienced this change to a very small degree as a result of my crisis.

2 = I experienced this change to a small degree as a result of my crisis.

3 = I experienced this change to a moderate degree as a result of my crisis.

4 = I experienced this change to a great degree as a result of my crisis.

5 = I experienced this change to a very great degree as a result of my crisis.

I have a greater appreciation for the value of my own life.

I have a better understanding of spiritual matters.

I established a new path for my life.

I have a greater sense of closeness with others.

New opportunities are available which wouldn’t have been otherwise.

I put more effort into my relationships.

I discovered that I’m stronger than I thought I was.

The module teaches soldiers interactively about five elements that are known to contribute to post-traumatic growth. The first element is to understand the response to trauma itself: shattered beliefs about the self, others, and the future. This is, I want to emphasize, the normal response to trauma; it is not a symptom of post-traumatic stress disorder, nor does it indicate a defect of character. The second element is anxiety reduction, which consists of techniques for controlling intrusive thoughts and images. The third element is constructive self-disclosure. Bottling up trauma likely leads to a worsening of physical and psychological symptoms, so soldiers are encouraged to tell the story of the trauma. This leads to the fourth element: creating a trauma narrative. The narrative is guided, with the trauma seen as a fork in the road that enhances the appreciation of paradox. Loss and gain both happen. Grief and gratitude both happen. Vulnerability and strength both happen. The narrative then details what personal strengths were called upon, how some relationships improved, how spiritual life strengthened how life itself was better appreciated, and what new doors opened. Finally, overarching life principles and stances that are more robust to challenge are articulated. These include new ways to be altruistic, accepting growth without survivor guilt, crafting a new identity as a trauma survivor or a newly compassionate person, and taking seriously the Greek ideal of the hero who returns from Hades to tell the world an important truth about how to live.

Master Resilience Training

The first two components of CSF are the Global Assessment Tool and the five online fitness courses. The real challenge is training, however. Can the army train soldiers to become more psychologically fit, just as the army trains for physical fitness? At the November 2008 meeting, General Casey ordered us to come back in sixty days and report. Sixty days later, we were back at lunch at the Pentagon.

“We have developed a test to measure psychological fitness, sir,” General Cornum said to General Casey. “It takes only twenty minutes, and it has been constructed by a group of the leading civilian and military test experts. We are piloting it now with several thousand soldiers.”

“Fast work, General. What do you and Marty want to do next?”

“We want to do a pilot study on resilience training.” Rhonda and I had planned our response to this question at length. “Marty has shown in his work on positive education that ordinary schoolteachers can be taught to deliver resilience training effectively to adolescents. The students then have less depression and anxiety. Who are the schoolteachers in the army? The sergeants, of course. [The drill sergeants, my God!] So here is what we want to do: a proof-of-concept study in which we take one hundred sergeants at random and give them master trainer resiliency classes for ten days at Penn—teaching the teachers. These sergeants will then train the soldiers under their command in resilience. We can then compare these two thousand soldiers to a control group.”

“Hold on,” General Casey thundered. “I don’t want a pilot study. We’ve studied Marty’s work. They’ve published more than a dozen replications. We are satisfied with it, and we are ready to bet it will prevent depression, anxiety, and PTSD. This is not an academic exercise, and I don’t want another study. This is war. General, I want you to roll this out to the whole army.”

“But, sir,” Rhonda began gently to demur. As she started to enumerate all the bureaucratic and budgetary steps a whole-army rollout entails, my mind wandered back to a memorable conversation on the streets of Glasgow, Scotland, three years before with Richard Layard.

Richard is a world-class economist from the London School of Economics. In medieval monasteries, the post of abbot bridged the worlds of the secular and the sacred. This is the role that Richard plays in British politics, bridging academic research and the real political scrum. He is also the author of Happiness, a radical view of government in which he argues that government policy should be measured not by increases in gross domestic product but by increases in global well-being. He and his wife, Molly Meacher, are one of only two couples in the House of Lords. Merit lords, not hereditary lords.

Richard and I were strolling through a seedy section of Glasgow in between sessions of the inaugural event of Scotland’s Centre for Confidence and Well-Being, a quasi-governmental institution intended to counter the “c’nnot do” attitude said to be endemic to Scottish education and commerce. We were the keynote speakers.

“Marty,” Richard said in his mellifluous Etonian accent, “I’ve read your work on positive education, and I want to take it to the schools of the United Kingdom.”

“Thanks, Richard,” I said, appreciative that our work was being considered in high Labor Party circles. “I think I am just about ready to try a pilot study in a Liverpool school.”

“You don’t get it, do you, Marty?” said Richard, a mildly scathing tone in his voice. “You, like most academic types, have a superstition about the relation of public policy to evidence. You probably think that Parliament adopts a program when the scientific evidence mounts and mounts, up to a point that it is compelling, irresistible. In my whole political life, I have never seen a single example of this. Science makes it into public policy when the evidence is sufficient and the political will is present. I’m telling you that your positive education evidence is sufficient—‘satisficing,’ as we economists call it—and the political will is now present in Whitehall. So I’m going to take positive education to the schools of the United Kingdom.”

This was the single most sensible statement of the mysterious relationship between the micro and the macro that I have ever heard. It was a conversion experience for me. I emphasize it above for that reason, and if you are an academic and you remember nothing else from this book, remember what Lord Layard told me in Glasgow. The most frustrating experience of my professional life had been to see fine scientific ideas, backed by ample laboratory evidence, die again and again on some boardroom floor or just gather dust in the library. I wondered—and this is at the very heart of this book—why positive psychology is so popular now with the general public and in the press. It is certainly not that the evidence is irresistible. The science is quite new, and the evidence, if not scanty, is far from irresistible. Why had I worn out my knees begging granting agencies—often in vain—for so many years about learned helplessness, about explanatory style and depression, about cardiovascular disease and pessimism, when, now, generous individuals, unasked, would just write large checks upon hearing me lecture once about positive psychology?

As I tuned back in to the generals from this musing, General Cornum was reminding General Casey of all the budgetary and bureaucratic steps that she would have to go through and how long they took. “Battlemind, our current psychological program, sir, has been through only six of the ten steps, and it’s been around for more than a year.”

“General Cornum,” said General Casey, ending the meeting, “you are to make resilience training happen for the whole army. Move out.”

Talk about strength of will.

 

So the question that Rhonda and I confronted in February 2009 was how to disseminate resilience training rapidly and widely. We also had to figure out how to do it responsibly, allowing us to make trajectory corrections in the training materials as well as track its effectiveness, so that in the worst case, we could pull the plug on the program if it was not working.

The positive education teacher training course we had developed was written for civilian schoolteachers. Our first step now was to rewrite all the training material for sergeants and for their troops. Dr. Karen Reivich, Penn’s number one master trainer and the Oprah Winfrey of positive psychology, was in charge of “militarizing” the material. Over the next eight months, Karen and her staff met with more than a hundred Iraq and Afghanistan veterans and went over our training materials with them word by word.

Our first big surprise emerged from these conversations. We thought that our civilian examples—being dumped by a girlfriend or failing a test—would be irrelevant to warriors. How wrong we were.

“This is the first war that you have a cell phone and can call your wife from the front line,” observed General Cornum’s executive officer, Colonel Darryl Williams. A six-foot-three-inch West Point football star and Iraq veteran, he’d been the carrier of the “football” with the nuclear war codes for President Bill Clinton. “Watching out for improvised explosive devices is trouble enough, but squabbling about the dishwasher and the kids’ grades makes it worse,” he continued. “Much of the depression and anxiety our soldiers have is about what is going on at home. So your civilian examples fit well as they are. Just add some good military ones.”

We reworked the examples and began the full-blown Master Resilience Training (MRT) in December 2009. Now, every month, 150 sergeants come to Penn for eight days, and we simulcast the training to forts, where our Penn-trained facilitators were stationed. We spend the first five days providing the sergeants firsthand experience practicing the skills for use in their own lives as soldiers, leaders, and family members. They attend full-group sessions in which lead trainer Dr. Karen Reivich presents core content, demonstrates the use of the skills, and leads discussions. Following the plenary sessions, the sergeants go to thirty-person breakout sessions in which they practice what they learned using role playing, work sheets, and small-group discussion. Each breakout session is led by a trainer (trained by Karen) and four facilitators: two civilian (most of them master of applied positive psychology graduates) and two army (also trained by Karen). We have found that the ratio of five training-team members for thirty participants works well.

Following the first five days, the sergeants get a second set of materials (MRT trainer manual, MRT soldier guide, PowerPoint presentations) that they will use when they teach Master Resilience Training to their soldiers. Three full days are then devoted to preparing the sergeants with the depth of knowledge and teaching skills to deliver the program with fidelity. They work through a series of activities: role plays in which one sergeant assumes the role of teacher and five others assume the roles of soldiers; five-person teams of sergeants crafting challenging questions that must be answered by another five-person team; identifying delivery mistakes and content confusions during mock sessions led by the MRT trainer; and identifying the appropriate skills to use with actual soldier problem situations.

We divide the content of the training into three parts: building mental toughness, building strengths, and building strong relationships. All of these parts are patterned after the well-validated program we use to teach civilian teachers.

Building Mental Toughness

The theme of this part is learning the skills of resilience. We start with Albert Ellis’s ABCDE model: C (the emotional consequences) do not stem directly from A (the adversity) but from B (your beliefs about the adversity). This simple fact comes as a surprise to many of the sergeants, dispelling the common belief that adversity sets off emotion directly. The sergeants work through a series of professional A’s (You fall out of a three-mile run) and personal A’s (You return from deployment, and your son does not want to play basketball with you), with the goal of being able to separate the adversity (A) from what he says to himself in the heat of the moment (B) and from the emotions or actions his thoughts generate (C). By the end of this skill session, the sergeants can identify specific thoughts that drive particular emotions: for instance, thoughts about trespass drive anger; thoughts about loss drive sadness; thoughts about danger drive anxiety.

We then focus on thinking traps. I’ll give you an example. To illustrate the thinking trap of overgeneralizing (judging a person’s worth or ability based on a single action), we present the following: “A soldier in your unit struggles to keep up during physical training and is dragging the rest of the day. His uniform looks sloppy, and he makes a couple of mistakes during artillery practice. You think to yourself, He’s soup sandwich! He doesn’t have the stuff of a soldier.” Following this case, the sergeants describe the thinking trap and discuss its effects on the soldier he is leading and on the sergeant himself.

One sergeant commented, “I hate to admit it, but I think that way a lot. I write people off if they screw up. I guess I’m not big on second chances because I think you can judge a person’s character through their actions. If that guy had a strong character, he wouldn’t be dragging and his uniform wouldn’t be in disarray.” The sergeants then ask, “What specific behaviors explain the situation?” learning to focus on behaviors, as opposed to the soldier’s general worth.

We then turn to “icebergs,” deeply held beliefs that often lead to out-of-kilter emotional reactions (such as, “Asking for help is a sign of weakness”), and they learn a technique for identifying when an iceberg drives an out-of-proportion emotion. Once the iceberg is identified, they ask themselves a series of questions to determine: (1) if the iceberg continues to be meaningful to them; (2) if the iceberg is accurate in the given situation; (3) if the iceberg is overly rigid; (4) if the iceberg is useful. The iceberg “Asking for help shows weakness” is frequent and poignant, because it undermines the willingness to seek help and rely on others. This iceberg requires sergeants to do a lot of work to change because historically soldiers felt stigmatized if they sought out help and were often ridiculed for not being strong enough to handle their own problems.

Many sergeants commented that they believe the culture around help seeking is now shifting in the army. One sergeant commented, “There was a time when I would have called a soldier a [expletive] for seeing a counselor or going to a chaplain. And if I didn’t say it to his face, I sure would have thought it. I don’t see it that way anymore. Multiple deployments have taught me that we’re all going to need help from time to time, and it’s the strong ones that are willing to ask for it.”

Following icebergs, we deal with how to minimize catastrophic thinking. We are bad-weather animals, naturally attracted to the most catastrophic interpretation of adversity, since we are the descendants of people who survived the Ice Age. Those of our ancestors who thought, It’s a nice day in New York today; I bet it will be nice tomorrow, got crushed by the ice. Those who thought, It only looks like a nice day; here comes the ice, the flood, the famine, the invaders, oy! Better store some food! survived and passed down their brains to us. Sometimes thinking and planning for the very worst is useful; more often, however, it is paralyzing and unrealistic, so learning to calibrate the catastrophic realistically is a crucial battlefield and home-front skill.

Here the sergeants watch a video clip of a soldier unable to contact his wife via email. He thinks, She’s left me, and this produces depression, paralysis, and fatigue. Now we introduce a three-step model, “Putting It in Perspective,” for disputing catastrophic thinking: worst case, best case, most likely case.

You’ve called home several times and haven’t been able to reach your wife. You think to yourself, She’s running around on me.

That’s the worst case.

Now let’s put it in perspective. What’s the best possible case?

“Her patience and strength never waver even for a second.”

Okay, now what’s the most likely case?

“She’s out with a friend, and she’ll email me later tonight or tomorrow. My wife will rely on others instead of me while I’m deployed. I will be envious and angry when my wife relies on others; she will feel lonely and scared while I’m away.”

After the most likely outcome is identified, they develop a plan for coping with the situation, and then practice this skill with both professional examples (a soldier has not returned from a land navigation drill; you received a negative review from a superior) and personal examples (your child is doing poorly at school, and you are not home to help; your spouse is having a hard time managing the finances while you are deployed).

The Hot Seat: Fighting Catastrophic Thoughts in Real Time

These skills are used when there is a task that requires immediate attention, and performance will be compromised if the soldier is distracted by “mental chatter.” Examples include: going in front of a promotion board, leaving the forward operating base to check for improvised explosive devices, demonstrating your combat skills, or pulling into your driveway after a stressful day on post.

There are three strategies for challenging the catastrophic beliefs in real time: gathering evidence, using optimism, and putting it in perspective. Sergeants learn how to use these skills and how to correct unrealistic errors midstream (one time/one thing, owning the situation, and taking appropriate responsibility). This skill is not about replacing every negative thought with a positive one. It is designed to be a stopgap so that the soldier is able to focus right now and does not put himself (or others) at greater risk because of paralyzing, unrealistic thoughts. There is a time and place to focus on persistent negative thoughts because often there is something that can be learned from them.

For example, one sergeant said that he was constantly barraged by negative thoughts about whether his wife truly loved him and that these thoughts often interfered with his ability to stay focused. He believed the theme of his thoughts came from the iceberg “I’m not the kind of guy women love.” It is important to fight off these thoughts at certain times, such as when trying to get much-needed sleep or when engaging in high-risk maneuvers. It is also important to pay attention to these beliefs and thoughtfully evaluate them during the more appropriate breathing spells.

It is important that these mental-toughness skills perfectly capture the skills of learned optimism, the skills that resist learned helplessness. Recall that the aim of Comprehensive Soldier Fitness is to move the entire distribution of trauma responses toward more resilience and post-traumatic growth. But this should also have a preventive effect on post-traumatic stress disorder (the tail of the distribution). PTSD is a nasty combination of anxiety and depressive symptoms, and resilience (optimism) training has a clear preventive effect on both. It is, moreover, the soldiers in the bottom 15 percent in mental fitness and physical fitness who are particularly vulnerable to PTSD, so arming them in advance with antianxiety and antidepression skills should be preventive. Finally, in a 2009 review of 103 studies of post-traumatic growth, Italian researchers Gabriele Prati and Luca Pietrantoni found that optimism was a major contributor to growth. So the theory suggests that building mental toughness should both move soldiers toward growth as well as prevent PTSD. We won’t rest on theory, however, since the army will be measuring all of this very carefully. Stay tuned.

Hunt the Good Stuff

Throughout the program, the sergeants keep a gratitude journal (also called a three-blessings journal). The purpose of “Hunt the Good Stuff” is to enhance positive emotions; our rationale is that people who habitually acknowledge and express gratitude see benefits in their health, sleep, and relationships, and they perform better. Each morning of the MRT course, several of the sergeants share something that they had “hunted” from the day before, as well as their reflection on what the positive event meant to them. These range from “I had a great conversation with my wife last night; I used what we learned in class, and she said it was one of the best conversations we’ve ever had,” to “I stopped and talked to a homeless guy, and I learned a lot from him,” to “The owner of the restaurant didn’t charge us for our dinner as a way to say thank you to the army.”

As the week unfolds, the blessings become more personal. The morning of the final day, one sergeant said, “I talked to my eight-year-old son last night. He told me about an award he won at school, and usually I’d just say something like ‘That’s nice.’ But I used the skill we learned yesterday, and I asked a bunch of questions about it: Who was there when he got the award? How did he feel receiving it? Where’s he going to hang the award?

“About halfway through the conversation, my son interrupted me and said, ‘Dad, is this really you?!’ I knew what he meant by that. That was the longest we ever talked, and I think we were both surprised by it. It was great.”

Character Strengths

After the mental-toughness skills, we turn to identifying character strengths. The Army Field Manual describes the core character strengths of a leader: loyalty, duty, respect, selfless service, honor, integrity, and personal courage. We review these and then have the sergeants complete the online Values in Action Signature Strengths survey and bring to class a printout of their twenty-four strengths, ranked in order. We define “signature strength,” and the sergeants post their names around the room on large flip charts, each labeled with one of the strengths. Flip charts that are very full of Post-it notes reveal what the most common sergeant strengths are. The sergeants look for patterns within the group and discuss what the group strength profile reflects about them as leaders. Following this activity, small groups discuss: “What did you learn about yourself from the strengths survey? Which strengths have you developed through your service in the military? How do your strengths contribute to your completing a mission and reaching your goals? How are you using your strengths to build strong relationships? What are the shadow sides of your strengths, and how can you minimize these?”

We then shift the focus to using strengths to overcome challenges. Colonel Jeff Short of the Comprehensive Soldier Fitness team presents a case study that describes how he led his unit, the 115th, out of Fort Polk, Louisiana, to set up a combat support hospital at Abu Ghraib prison to provide all detainee health care, including inpatient and outpatient care. As Jeff describes the challenges of setting up the field hospital and caring for the detainees, the sergeants keep track of each instance of an individual or the team pulling on a character strength and the specific actions it enabled. For example, the field hospital needed a “wound vacuum,” but none was available. A nurse demonstrated the strength of creativity when she came up with a way to create one out of an old vacuum cleaner.

Next the sergeants break into small groups and tackle a mission that they need to complete as a unit. We instruct them to use their team’s character strengths to complete the mission, with the team using the strengths available. Finally, the sergeants write their own “Strengths in Challenges” stories. One sergeant described how he used his strengths of love, wisdom, and gratitude to help an undisciplined soldier who was acting out and stirring up conflicts. The sergeant used his strength of love to engage the soldier, whereas most others avoided the troublemaker because he was so hostile. The sergeant discovered that the soldier felt consumed by anger at his wife, and his anger spilled over to the soldiers in his unit. Then, operating from his strength of wisdom, the sergeant helped the soldier to understand the wife’s perspective and worked with him to write a letter in which the soldier described the gratitude he feels because his wife has to handle so much on her own during his three deployments.

Building Strong Relationships

Our final module focuses on how to strengthen relationships with other soldiers and at home. Our goal is to provide practical tools that build relationships and to challenge beliefs that interfere with positive communication. The work of Dr. Shelly Gable shows that when an individual responds actively and constructively (as opposed to passively and destructively) to someone sharing a positive experience, love and friendship increase. So we teach the four styles of responding: active constructive (authentic, enthusiastic support), passive constructive (understated support), passive destructive (ignoring the event), and active destructive (pointing out negative aspects of the event). We demonstrate each through a series of role plays. The first role play focuses on two privates who are close friends:

Private Johnson tells Private Gonzales “Hey, my wife called and told me she got a great job on post.”

Active constructive: “That’s great. What’s the new job? When does she start? What did she say about how she got it and why she deserved it?”

Passive constructive: “That’s nice.”

Passive destructive: “I got a funny email from my son. Listen to this …”

Active destructive: “So who’s going to be looking after your son? I wouldn’t trust a babysitter. There are so many horror stories you hear about babysitters abusing kids.”

After each role play, the sergeants complete a worksheet about their own typical ways of responding and identify what makes it hard for them to respond actively and constructively (such as being tired or being overly focused on themselves), as well as how they can use their signature strengths to stay active and constructive: for example, using the strength of curiosity to ask questions, using the strength of zest to respond enthusiastically, or using the strength of wisdom to point out valuable lessons to be learned from the situation.

We then teach Dr. Carol Dweck’s work on effective praise. What do you say when praise is warranted? For example: “I aced my PT test.” “We cleared the building without sustaining any casualties.” “I was promoted to master sergeant.” We teach the sergeants to praise the specific skills as opposed to a vague “Way to go!” or “Good job!” Praising the details demonstrates to their soldier (a) that the leader was really watching, (b) that the leader took the time to see exactly what the soldier did, and (c) that the praise is authentic, as opposed to a perfunctory “Good job.”

Finally, we teach assertive communication, describing the differences among passive, aggressive, and assertive styles. What is the language, voice tone, body language, and pace of each style? What messages does each style convey? For example, the passive style sends the message “I don’t believe you’ll listen to me anyway.” We found in our positive education work that a critical aspect is to explore the icebergs that lead to one style of communicating over another. Someone who has the belief “People will take advantage of any sign of weakness” tends toward an aggressive style. A person who believes “It’s wrong to complain” will have a passive style, and the belief “People can be trusted” brings about an assertive style.

So we teach a five-step model of assertive communication:

1. Identify and work to understand the situation.
2. Describe the situation objectively and accurately.
3. Express concerns.
4. Ask the other person for his/her perspective and work toward an acceptable change.
5. List the benefits that will follow when the change is implemented.

The sergeants practice this with military scenarios: your battle buddy has started drinking too much and has been seen drinking and driving; your husband is spending money on things you don’t consider essential; a fellow soldier continues to take your belongings without asking permission. Following these role plays, the sergeants identify a thorny situation that they are currently confronting and practice using assertive communication. One poignant area is exploring how they talk to their own families. Many sergeants tell us they communicate too aggressively with spouses and too forcefully with their children because it is difficult to change from the fast-paced, command-oriented world of their job to the more democratic focus that works so much better at home.

One sergeant stopped me in the hallway after this session and thanked me, saying, “If I had learned this stuff three years ago, I wouldn’t be divorced.”

In spite of the intention to help our soldiers and others through my work with the army, as I’ve discussed in these two chapters, some journalists have chosen to look at it through a glass darkly and persist in searching for some nefarious intent on my part to use science to harm. Some critics have claimed that this program “brainwashes” soldiers with positive thinking: “Moreover, wouldn’t soldiers like their officers to consider worst-case scenarios before ordering them into combat?… The healthy option to negative thinking is not positive thinking but critical thinking.” We do not teach mindless positive “thinking.” What we teach is critical thinking: the thinking skills to distinguish between irrational worst-case scenarios that paralyze action and the more likely scenarios. This is a thinking skill that enables planning and action.

Other critics have even implied that I supported the use of my work in learned helplessness for the purposes of psychological intimidation and the torture of detainees and supposed terrorists by some parts of the military during the George W. Bush administration’s so-called war on terror.

This could not be further from the truth. I have never and would never provide assistance in torture. I strongly disapprove of torture. I condemn it.

Here is what I know about the torture controversy: the military’s Joint Personnel Recovery Agency invited me to give a three-hour lecture at the San Diego Naval Base in mid-May 2002. I was invited to speak about how American troops and American personnel could use what is known about learned helplessness to resist torture and evade successful interrogation by their captors. This is what I spoke about.

I was told then that because I was (and am) a civilian with no security clearance, they could not detail American methods of interrogation with me. I was also told then that their methods did not use violence or brutality.

Yet a report dated August 31, 2009, by the Physicians for Human Rights states: “In fact, on at least two occasions, Seligman presented his learned helplessness research to CIA contract interrogators referred to in the Inspector General’s report.” This is false. The “interrogators” were presumably James Mitchell and Bruce Jessen, two psychologists who have been reported to have worked with the CIA to help develop “enhanced” interrogation methods. They were in the audience of between fifty and one hundred when I presented my research on learned helplessness. I did not present it “to them.” I presented it to the Joint Personnel Recovery Agency, and, again, I spoke about how American troops and American personnel could use what is known about learned helplessness to evade successful interrogation by their captors. There was no other occasion on which I presented my research to Mitchell and Jessen or to anyone else associated with this controversy.

I have not had contact with Joint Personnel Recovery Agency since that meeting. Nor have I had professional contact with Jessen and Mitchell since then. I have never worked under government contract (or any other contract) on any aspect of torture, nor would I ever be willing to do work on torture.

I have never worked on interrogation; I have never seen an interrogation, and I have only a passing knowledge of the literature on it. With that qualification, my opinion is that the point of interrogation is to get at the truth, not to get at what the interrogator wants to hear. I think learned helplessness would make someone more passive, less defiant, and more compliant, but I know of no evidence that it leads reliably to more truth telling. I am grieved and horrified that good science that has helped so many people overcome depression may have been used for such dubious purposes.

The Rollout

We were, frankly, nervous that these hard-boiled drill sergeants of legend would find resilience training “girly” or “touchy-feely” or “psychobabble.” They did not, and more important, they loved (there is no more apt word for it) the course. To our amazement, the training received a rating of 4.9 out of 5.0 overall, with Karen Reivich receiving 5.0 out of 5.0 in their anonymous evaluations. Their comments brought tears to our eyes.

The most enjoyable, but more importantly, insightful training I have received since being in the army.

I am amazed at how simple but greatly effective this course was for me. I can only imagine the impact it will have on my soldiers, family, and the army as a whole.

This will save lives, marriages, and prevent suicides and other things like alcohol dependency and drug use post deployment. It needs to get to soldiers downrange now.

We need every soldier, army civilian, and family member to receive this training.

I’ve already started using my newfound techniques in my family life.

And this is truly a representative sample of the evaluations from the allegedly grizzled drill sergeants.

Here is the rollout plan: for 2010, 150 sergeants will come to Penn each month for eight days of training to become the trainers. Another large group of sergeants will receive a simulcast of the training at their home forts. We will select the best of the sergeants to become master trainers and to be cofacilitators with our Penn trainers, so that by the end of 2010, we will have trained about 2,000 sergeants and will have selected and trained up to 100 of them to become the master trainers. These sergeants will devote one hour per week to resilience training. In 2011 we will continue to train at Penn as well as migrate the training into the forts. In the not too distant future, resilience training will be taught to all incoming soldiers, and the army will fully staff the training.

When General Casey, General Cornum, and I briefed the two-and three-star generals, their first question was “What about our wives and kids? The resilience of a soldier directly reflects the resilience of his family.” General Casey thereupon ordered that the entire army family would have access to resilience training and that this would be an addition to Rhonda’s portfolio. So we are creating mobile units, consisting of a lead trainer and a staff of master trainers to deploy and teach resilience to distant outposts such as Germany and Korea, as well as to spouses and kids.

In the meantime, we have been getting letters from the “front.” Here’s what Staff Sergeant Keith Allen wrote us:

Being an infantry soldier, I’m used to getting concrete details about any mission given me. When I was told I’d be attending Master Resilience Training, I naturally asked what I could expect … I was told to keep an open mind. Being a soldier, I translated this as “This will probably be worthless, but we’ve been ordered to support it.”

I came to the training fully expecting to encounter teams of psychologists who would talk over my head, or would have nothing relevant to offer, or both. On the first day of class, I (along with the two NCOs from my unit) came to the classroom thirty minutes early, hoping to select a seat in the back row. To our chagrin, all the other participants had the same plan … The only seats remaining were in the front row.

We occupied the seats. I, admittedly, sat in the classic non-believer pose (slumped back in my chair, with my arms folded across my chest). By the second day, I found myself sitting upright, engaged in the class. By the time we were into Avoiding Thinking Traps, I was leaning forward in my chair, fully surprised and somewhat disappointed when it was time to break for meals.

I recognized some of the skills as things I may have done instinctively or as a result of finding success with the methods through experience. I recognized the lack of some of the skills in some of the leaders/peers/soldiers I have encountered throughout my career.

When the discussion turned to our Values in Action Character Strengths results, I eagerly anticipated discussion. Some things were right where I thought they should be; others, to my surprise, were not as high on my list of strengths as I would have thought. After honest reflection (self-awareness), and communication with my wife, I realized my strengths were in a pretty accurate order. Knowing which strengths were lower than I would have thought showed me where to direct some of my efforts in the future.

I have used these skills since returning to my unit with success. Equally as important, if not more so, I have found success with my family. Some of our decisions in my unit are collaborative in nature; when I offer my input, I now have firm language to use to describe how I arrive at some of my decisions. My commander and senior leaders have since pulled me aside and asked more about Master Resilience Training. Two of them will be in the next training. Two of my children (fifteen and twelve years old, respectively) have taken the VIA, and it has helped our interaction. I have used active-constructive responding and taken my twelve-year-old through problem solving, and we both found unexpected success.

Staff Sergeant Edward Cummings wrote:

I went through Master Resilience Training last November, and since the course, it has done nothing but help me, not only in my professional life but more importantly in my personal life. My philosophy with the army is that if you are happy and successful at home, it will only help you at work … From the beginning of the course, I began to learn how to interject this into my everyday life. It has opened new doors for me to be able to talk to my wife and more importantly to listen. I have caught myself so many times doing the passive constructive, which, after taking a step back and knowing what I was doing, I didn’t realize I was actually harming my marriage. By just listening to my wife about something I used to consider mundane, I found that her days got better, and as we all know, “If the wife ain’t happy, nobody is happy!”

I have found myself able to handle struggles at work a lot easier as well. I used to get very upset when things weren’t going as I thought they should and usually overreacted. Now I take that step back … try to get all of the information before making a rash decision. It has helped me calm down and approach those types of situations differently. I have found many icebergs and now can actually do something about them …

I used to wonder if I would be like my parents and have a marriage that would last thirty-six-plus years; now I am more confident that I will. I used to worry about my career and dwell on so many different choices I have made in my career and wonder if I did the right thing and if I would be a success. Now I know that no matter what happens in the future, I will be able to better take on the challenges. With this knowledge, I will be able to better take care of soldiers as well. I believe that if you cannot take care of yourself, how can you take care of soldiers? There are a lot of new soldiers who have a very hard time adjusting to the army life and time away from loved ones. I used to be one. If I had this information back then, I know I would have been a lot better off and able to handle the challenges better. With this knowledge, I know when the soldiers come to me with an issue, I can use some of the different techniques such as the ABCs, problem solving, or be able to identify their icebergs and be able to help them and do my job as their leader …

Overall the course was a great success … I have told my family about it and many friends who are going through tough times. The use of positive psychology is awesome!

The army and Penn will not rest easy with testimonials only. The outcome of our training will be evaluated rigorously in a massive study under the command of Colonel Sharon McBride and Captain Paul Lester. Since Master Resilience Training rolls out gradually, we will be able to evaluate the performance of the soldiers who have had resilience training in contrast to those who have not yet had it. This is called a “wait-list control” design. At least 7,500 soldiers who have been taught the materials of the Penn Resiliency Program by their sergeants will be followed for the next two years. They will be compared to soldiers who have not had the training. McBride and Lester will be able to ask if resilience training produces better military performance, less PTSD, better physical health, and ultimately a better family life and civilian life when they come back home.

This chapter would not be complete unless I confessed my deepest feelings about working with the army. I view the United States as the country that gave my grandparents, persecuted unto death in Europe, a safe haven where their children and grandchildren would flourish. I view the U.S. Army as the force that stood between me and the Nazi gas chambers, and thus I count my days with the sergeants and the generals as the most fulfilling and gratitude laden of my life. All my work with Comprehensive Soldier Fitness is pro bono. As I sit with these heroes, this verse from Isaiah 6:8 comes back to me:

“Whom shall I send? And who will go for us?”

And I said, “Here am I. Send me!”