AT EITHER END of the long table sat a brigadier general. Both were women. In the middle of the table sat a constellation of two-and three-star generals. They were all men. The four-star chief of staff of the US Army walked in. Everyone jumped to attention, and I, the only civilian, stumbled to my feet. General George Casey took the chair in the middle, across from me. It was December 2008, and the war was raging in Iraq. President George W. Bush had, with fulsome praise, kicked General Casey upstairs from the battlefield to the Pentagon, to be replaced in the field by General David Petraeus. Petraeus’s surge seemed to be taking hold, but mental illness plagued the army itself—hence my invitation to the Pentagon.
“Suicide, drug abuse, posttraumatic stress disorder, panic, depression, divorce,” began General Casey, speaking deliberately but with an undertone of skepticism. “What does positive psychology say about all that, Dr. Seligman?”
“The human reaction to awful events like combat, Sir, is bell-shaped,” I began, reflexively using the honorific that I learned in the battalion at the Albany Academy for Boys. “You have just described the left-hand side of the bell, the different names for the ways in which people’s lives are ruined. But most people are resilient, which means they go through a tough time in combat and then a few months later, by all our physical and psychological measures, they are back where they were before combat.
“More important and much less publicized,” I continued while focusing my eyes on a major general without a left leg, “is posttraumatic growth, the right-hand side of the bell curve. These are the soldiers who go through a terrible time in combat but one year later are stronger—by our physical and psychological measures—than they were to begin with. The army is not a hospital, and of course you should continue to spend the billions of dollars it takes to help those who have their lives ruined, but my advice, Sir, is to move the whole curve rightward, toward posttraumatic growth.”
“The general staff has done its homework, Dr. Seligman,” General Casey replied. I could see from the books they were carrying, including my latest, that they were well prepped. “I intend to create an army that is just as psychologically fit as physically fit. We have read your work on positive education. We know that you teach teachers the skills of resilience and positive psychology and that you have found that young people who learn your material from their teachers have less depression and more well-being. That’s the army way. We have 40,000 teachers in the army.”
“You do, Sir?”
“The drill sergeants,” he said with finality, and then, unlike you and me, who, when we have a good idea, try to convince our colleagues, General Casey now commanded, “I want the drill sergeants taught the skills of resilience and positive psychology, and the drill sergeants will then teach the 1.3 million soldiers. From this day forward, resilience and positive psychology will be taught and measured throughout the entire United States Army. I intend to create an army that is just as psychologically fit as physically fit.
“To do this I want you to work with one of the brigadier generals, Dr. Seligman.”
I glanced at Brigadier General Loree Sutton, the army’s chief psychiatrist, at the left end of the table. I had heard a bit about her; it was said she was staging Greek tragedies with traumatized soldiers as her actors, getting them to open up and pour out their hidden emotions. This was not my kind of intervention. But General Casey, to my relief, pointed to the right end of the table.
“Dr. Seligman, meet Rhonda Cornum. Rhonda is the chief urologist of the army, and I want you to work with her to create ‘Comprehensive Soldier Fitness.’ Report back to me in sixty days.”
“I will be delighted to work with a star neurologist, Sir,” I answered.
“Urologist,” Rhonda corrected, and on this off-note began one of the farthest-reaching collaborations of my life.
TWO DAYS LATER Rhonda drove her RV up from the Pentagon to my office at Penn’s Positive Psychology Center to plan. At five-foot-two and one hundred pounds, she was pert, with short-brown hair, and dressed in unflattering army camouflage.
She was laconic and used humor to drive home her points. “Better is the enemy of the good,” she told me when I suggested too many experts. “He needs some adult supervision,” she said when I recommended a captain. She was also a war hero, the only female general to hold the Purple Heart, having been wounded in combat.
During Operation Desert Storm she went on a rescue mission. Her helicopter was shot down, and all the men jumped on her to protect the physician with their bodies. Unfortunately, the bullets were coming up from below, and all but Rhonda and one other soldier died. She suffered two broken arms, a broken finger, a gunshot wound, and other injuries. She was taken prisoner and sexually molested. Saddam Hussein and President George H. W. Bush negotiated her release.
“It’s too bad you’re a woman, Major,” the welcoming colonel told her when she arrived back in Saudi Arabia from prison, “otherwise you could be a general.” A general she became and—as I discovered somewhat later, seeing how at Fort Leavenworth 1,200 majors and colonels had risen to their feet applauding her—not just any general but the poster child general.
Creating a psychologically fit army required two things. First we needed a measure of psychological fitness, not just the usual measures of unfitness: mental illness, indiscipline, substance abuse, felonies, dishonorable discharges. We needed good measures of a soldier’s well-being, resilience, character strengths, social support, sense of purpose, growth, and positive emotion—the positive sides of a soldier’s life, since Comprehensive Soldier Fitness (CSF) aimed explicitly to increase the well-being of all soldiers not just to reduce negatives. Second, we needed a plan for building well-being and resilience, a plan to move the entire army toward the right-hand side of the bell curve—toward posttraumatic growth.
For the first, we convened a meeting of measurers the very next week, right before Christmas 2008, in my office. I came down with the flu, and they excused me after my opening remarks. Chris Peterson chaired the meeting along with Colonel Carl Castro. Nansook Park, Chris Peterson’s right hand, was the workhorse. Taking the best items from a variety of personality inventories, they constructed a 120-item Global Assessment Tool (GAT) and started the pilot work right away.
“REPORT,” GENERAL CASEY instructed. Same lunch table, same generals—it was mid-February 2009, and I was jet-lagged, just back from teaching positive psychology to Geelong Grammar School teachers in Australia.
“We developed a questionnaire to assess soldiers’ well-being, resilience, and character strengths, as well as the usual deficits and problems,” Rhonda said, “and we piloted it with ten thousand soldiers, Sir.” She actually called 10,000 subjects pilot work.
“Good work, General Cornum. What are you and Marty [I blushed when General Casey used my first name] going to do by way of building resilience and positive psychology in the army?”
“We’d like to run a pilot study with one hundred drill sergeants and five thousand soldiers,” Rhonda said. She and I had discussed this at length and decided to go slowly and carefully. “Each sergeant will teach fifty soldiers resilience skills and then for the next year we will gather data—”
“We are at war, General Cornum,” interrupted General Casey. “I don’t want a pilot study. I want you to teach and measure resilience and positive psychology in the whole army now.”
“Move out, Soldier!” he said and left the table. We snapped to our feet.
So Rhonda and I had three huge tasks. The first, creating a viable test of resilience and well-being for more than 1 million soldiers, was well underway. The second was to craft an intervention that had a shot, in the absence of serious pilot work, at building resilience in soldiers. The third was to measure—in the midst of war—if soldiers were actually learning more resilience.
Karen Reivich now enlisted to build the intervention. Karen had been teaching resilience and positive psychology to hundreds of schoolteachers, most recently at the Geelong Grammar School. The drill sergeants were indeed teachers, but of a very different stripe. How could we modify the extensive manuals we used to teach teachers in peacetime to teach drill sergeants in the middle of a hot war?
We needed to combine what we’d learned teaching civilian teachers with the issues that overwhelmed soldiers in Iraq and Afghanistan. So Karen mixed two teams together: the first comprised our five best teachers of ordinary schoolteachers, and the second consisted of soldiers, from colonels to corporals, all of whom had served on the front lines. We had already created massive minute-by-minute manuals for teaching schoolteachers and modified them to teach drill sergeants. In an eight-day program for schoolteachers we started first by teaching the teachers to use the skills of resilience and positive psychology in their own lives and only then taught them how to teach the skills to schoolchildren. So we planned to first teach the sergeants to use the skills on themselves and then develop the techniques for teaching the soldiers.
We were surprised by the similarity in the issues faced by both soldiers and civilians. Before meeting the soldier team to redo the manuals, we assumed new material would deal primarily with firefights, roadside bombings, and dealing with hostile as well as innocent civilians. How can you remain resilient when your best buddy has just been decapitated?
We were soon disabused of this CNN-stereotyped warfare in Iraq.
“This is the first war in which soldiers have cellphones,” a major reminded us. “Before a battle a worried private will call his girlfriend in Saint Louis, and they will have a huge fight. When we see suicide attempts or posttraumatic stress, troubles back at home loom as large as firefights in Iraq.”
So as we wrote the new manuals for the drill sergeants, we coupled examples from army life and ordinary home life. Take for example an exercise to correct catastrophization (the worst possible interpretation applied to an ambiguous situation) by transforming it into a more realistic interpretation. The exercise, called “Put It in Perspective,” aimed to lower the panic and anxiety set off by the worst interpretation of a bad event.
Army life:
You and your squad are out on a land navigation course. It is twenty minutes past the midnight deadline, and one of your soldiers has not shown up.
Step one is to list the worst possibilities:
- He’s got heat stroke.
- He’s probably dead.
- It’s my fault, and I will rot in jail the rest of my life.
Step two is to list the best possibilities:
- He’s taking a nap.
- He’s 100 meters away and will be here in a few minutes.
Step three is to list the most likely possibilities:
- He got lost.
- He’s hitchhiking back.
- I will have to report him, and the captain will bawl me out.
Now develop a plan for dealing with the most likely outcomes.
- Find out who saw him last.
- Send out a couple of guys with a vehicle to look for him.
Home life:
You phone your girlfriend late at night in the United States, and she does not answer.
Worst outcome?
- She’s out on a date with another man.
- She’s having an affair.
- It’s all over.
Best outcome?
- She’s asleep and does not hear the phone.
- She’s staying overnight at her mother’s house.
Most likely outcome?
- She’s gone out drinking with her girlfriends.
- She’s tempted by other guys.
Now formulate a plan for dealing with the most likely outcomes.
- Outline an understanding script about how lonely you both are.
- Rehearse it with your best buddy.
THE MANUAL STARTED with a panoply of such resilience, or “mental toughness,” exercises. This took up the first two or three days of the program. In the next two days, the sergeants (20 percent of whom were female) learned to identify their signature strengths, as well as the strengths of the soldiers in their platoons, and how to deploy the range of strengths to carry out actual missions. Finally, we taught “building strong relationships,” a scientifically informed version of inculcating leadership skills. So, for example, we taught how to impart effective praise. When you recognized someone and offered praise, we suggested naming the specific strength, strategy, effort, or skill that had led to the good outcome. It just takes another sentence. Naming the strength does three things:
- Demonstrates you were really watching
- Demonstrates authenticity
- Enables winning streaks
We piloted the program successfully with several hundred drill sergeants, and after months of negotiations, the army and Penn entered into a $30 million contract to train thousands of drill sergeants and other noncommissioned officers over the next three years. My work was entirely pro bono.
Accordingly, once a month about 180 drill sergeants showed up at the Penn Sheraton Hotel for a nine-day course. As of this writing, we have trained more than 40,000 trainers. They were not shy and were more candid critics than our polite, housebroken schoolteachers. The sergeants were typically black or Hispanic soldiers originally from tough urban neighborhoods and had done three often heroic tours of duty in Iraq or Afghanistan. They had seen it all and were forthright about their opinions.
I should say that after going to faculty meetings for fifty years, I have yet to meet a faculty member I would trust my life to. In the course of this work, I have now met dozens of sergeants that I would trust my life to.
I will present some numbers about the effectiveness of this training below, but the sergeants’ reactions were dramatic and more to the point. At the outset of the first hour, they were leaning away from us with facial expressions that ranged from stolid indifference to sucking on a lemon. They were thinking something like, “What is this emasculating psychobabble that we have been ordered up to Philadelphia to listen to?” By the end of the first hour, they were leaning forward, intrigued. By the end of the last day, three-quarters of them had volunteered to become trainers of trainers, the next level of teaching. Their average rating of the entire program was about 4.9 out of 5.0, and the modal and emblematic comment was “This is the single best course I have had in twenty years in the army.”
The drill sergeants told us many times that these skills were “life-saving,” but my guess is that the real effect was on the home front.
One morning I came in very early to the Sheraton and sat down to breakfast. A master sergeant whom I had met the day before, when we taught active constructive responding to good events, joined me.
“I couldn’t wait to tell you that something really cool happened last night after class, Sir,” he said, barely restraining himself. “I called home, and my son answered. He was so excited. He hit a home run in Little League and won the game. We chatted for about five minutes, and then he said, ‘Dad, is this really you?’”
These skills are useful on the battlefield, but they are at least as useful at home with the people you love. One sergeant told me that taking this course when he was younger would have saved his marriage.
We planned carefully to get good data on whether the program actually worked, using untreated control groups and random assignment of sergeants to training or no training. We originally designed the rollout of the training so that 10,000 soldiers would have resilience training and 10,000 controls would not, a nice clean experiment. But the reality of war thwarted us. The sergeants’ reception to this course was so overwhelmingly positive that the generals sped up the rollout, wiping out our neat control group. So our well-designed experiment went up in smoke. In the meantime, the army decided to create a giant electronic database housed in Monterrey, California, and for the very first time at least thirty siloes of data—formerly separated and unanalyzable—millions of soldiers were merged into the Person-Event Data Environment. This became a national treasure for civilian and military medical research, and you will hear more about its power for scientific discovery in the next chapter. In the absence of a controlled experiment, Major Paul Lester and his team of statisticians in Monterrey did their very best to get before-and after-deployment data to see if resilience-trained soldiers actually fared better.
Looking at soldiers’ psychological status before and after deployment to Iraq or Afghanistan, they found that the soldiers (n = 6,739) who had resilience training improved in emotional fitness, active coping, and optimism and catastrophized less in contrast to the soldiers (n = 3,218) who had no resilience training and actually dropped in these measures by the end of their deployments.1
Since these were self-reported data, the army under Major Lester went on to look at the diagnosis of mental illness. Significantly fewer soldiers who had resilience training were diagnosed with posttraumatic stress disorder, anxiety, and depression, and the rate of substance abuse was halved.2 Based on these findings the Department of the Army declared the program “effective” and institutionalized it throughout the service.3 The program is now available to the families of soldiers as well as to the soldiers themselves.
At the outset I told the generals that I wanted to migrate the program to the army and not have the army dependent on me and the University of Pennsylvania. So each month we picked out the most skilled sergeants to become trainers of trainers. They then delivered the resilience training to other sergeants on army bases throughout the world. By now we have at least five hundred skilled trainers of trainers, most of whom were sergeants.
Given these successes, I was surprised by the harshness of the criticism the program unleashed. But I was not surprised by who the critics were. They were the very same people who accused me of designing the enhanced interrogation program for the CIA. Here are their criticisms and my responses.
IT SHOULD NOT have been undertaken, or if undertaken, it should have been done much more slowly. According to R. Eidelson, M. Pilisuk, and S. Soldz,
It is highly unusual for the effectiveness of such a huge and consequential intervention program not to be convincingly demonstrated first in carefully conducted, randomized, controlled trials—before being rolled out under less controlled conditions. Such preliminary studies are far from a mere formality.4
General Cornum and I proposed to first do a big pilot study on 5,000 soldiers, but the chief of staff overruled us. In his view, a pilot study would take years, and the results would come in too late to help our soldiers in Iraq and Afghanistan. There were, however, twenty-one replications of the procedures on middle and high school students.5 In the absence of any resilience program that met Eidelson, Pilisuk, and Soldz’s requirements, General Casey, we believe, made the wise choice: a program reasonably likely to work rather than no program at all or one that came too late.
Brigadier General Rhonda Cornum, the author, and Army Chief of Staff George Casey at a Comprehensive Soldier Fitness gathering. Photo courtesy of Rhonda Cornum.
IT DID NOT work, and it was a waste of money. The Institute of Medicine report Preventing Psychological Disorders in Service Members and Their Families6 said,
More recently, in another internal non-peer-reviewed report, The Comprehensive Soldier and Family Fitness Program Evaluation Report #4: Evaluation of Resilience Training and Mental and Behavioral Health Outcomes, Harms et al. (2013) examined psychological health diagnosis outcomes for 7,230 soldiers who received the GAT before Master Resiliency Training was initiated (October 2010) and again approximately 6 months later (about April 2011)…. Findings revealed … no difference in diagnosis among those receiving the intervention.
This is an egregious error. Here is what Report Number 4 showed for the diagnosis of mental disorders in these 7,230 soldiers:
1. In the Master Resilience Training (MRT) condition, the diagnosis of substance abuse occurred in 1.16 percent of soldiers, whereas in the nontraining condition, the diagnosis of substance abuse occurred in 2.85 percent of soldiers. MRT more than halved substance abuse.
Projected across 1 million soldiers (there were 1.1 million soldiers in the army at the time), this would equate to 11,600 as opposed to 28,500 cases of substance abuse, a difference of 16,900. If each case cost the army $20,000 (I am making this number up, but it is likely a substantial underestimate), MRT would save the army $340 million—to say nothing of massively reducing suffering.
2. In the MRT condition 4.44 percent of soldiers were diagnosed with posttraumatic stress disorder, panic, or depression. In the nontraining condition 5.07 percent were so diagnosed. Projected across 1 million soldiers, 44,400 cases would have occurred with MRT and 50,700 with no MRT, a difference of 6,300 cases. If each case costs the army $20,000 (again my made-up number but conservative), MRT would save the army $125 million—to say nothing of reducing suffering.
COMPREHENSIVE SOLDIER FITNESS is unethical. R. Eidelson, M. Pilisuk, and S. Soldz wrote,
No evidence was provided indicating that CSF received preliminary review by an independent ethics review board. This is particularly disturbing since the program includes components that are mandatory for all U.S. soldiers. The discarding of informed consent protections is a serious violation of the Nuremberg Code established after World War II in response to the actions of Nazi doctors.7
Here is how the army responded to congressional staffers about this:
According to Army Regulation 70-25 (Use of Volunteers as Subjects of Research, 1990, p. 17), research is defined as: “A systematic investigation that is designed to develop or contribute to generalized knowledge. The term does not include individual or group training of military personnel such as combat readiness, effectiveness, proficiency, or fitness exercises.” As CSF is a training program that supports and impacts all Soldiers and there is no expressed intent to create generalized knowledge, the program does not fit the definition of research. [Italics mine]
CSF has the same status as training programs that require all soldiers to do morning physical training, and to attend classes about how to recognize signs of suicide and sexual harassment, how to resist when captured, or why to wear safety belts when driving. These programs do not require informed consent.
CSF HARMS SOLDIERS. According to Eidelson, Pilisuk, and Soldz,
There are, however, other ethically fraught possibilities … “moral injury” … the challenges and consequences soldiers face in response to “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Resilience training could, for example, harm our soldiers by making them more likely to engage in combat actions that adversely affect their psychological health. Missing from CSF is a component devoted to helping soldiers grapple with the profound ethical dilemmas involved in their duties, including killing in furtherance of state policy.8
Similarly, Bruce Levine, a blogger, ranked CSF number six on his list of the ten worst abuses of psychiatry and psychology.9 Why? Because it subverted “U.S. Soldiers’ resistance to the military-industrial complex.” As the only evidence that this might be so, he wrote, “In one role-play used in this program, a sergeant is asked to take his exhausted men on one more difficult mission, and the sergeant is initially angry and complains that ‘it’s not fair’; but in the role play, his ‘rehabilitation’ involves reinterpreting the order as a compliment.”
Here is what the Office of Comprehensive Soldier Fitness stated in response to congressional inquiry about these allegations:
The authors of the article expressed concern that CSF training might actually cause harm. Current data analyses show that there is no evidence that CSF causes harm (Office of Comprehensive Soldier Fitness, 2011). These critics wanted a program that would lead soldiers to oppose American foreign policy, to defy orders, and to avoid combat. CSF does not bear on any of these—one way or another. Rather the results showed that soldiers who participated in CSF training
- Had greater emotional fitness
- Were more adaptable
- Thought in less catastrophic terms when faced with adversity
- Employed their core character strengths more often
- Had better coping skills
- Were more optimistic
- Perceived the Army as being more supportive of their family’s needs.
CSF WAS A reward for my assisting the CIA torture program. Daniel Tencer wrote,
A psychologist whose research was used in constructing the US’s program to torture terrorism suspects has been granted a $31-million no-bid Army contract to provide “resilience training” to US soldiers.
Mark Benjamin at Salon.com reports that University of Pennsylvania psychologist Martin Seligman’s research “formed the psychological underpinnings of the Bush administration’s torture program.”
The Army awarded the “sole source” contract in February to the University of Pennsylvania for resilience training, or teaching soldiers to better cope with the psychological strain of multiple combat tours. The university’s Positive Psychology Center, directed by famed psychologist Martin Seligman, is conducting the resilience training.10
The clear implication is that Comprehensive Soldier Fitness was some kind of nefarious reward for my allegedly helping construct the enhanced interrogation program. But I did not assist or abet the interrogation program, so there could have been no such “reward.” Nor was my work on learned helplessness the basis of the enhanced interrogation program.11 Since helping the US Army make our soldiers more resilient has been one of the personal and professional high points of my life, I find this accusation unjust and insulting.
Here are the facts. The University of Pennsylvania received a sole-source, no-bid $31-million contract to train US Army personnel in resilience and positive psychology. This was sole-source, no-bid because there existed no other known entities besides Penn to compete for this contract. The chief of staff of the army, George Casey, viewed this as very urgent. He was in a rush to get such a program started to help our troops as soon as possible. I believe the army decided to sole-source the contract for the following reasons:
- Penn was the only known entity that had done extensive training and published extensive peer-reviewed research on resilience training.
- Penn was the only known entity that had extensive experience in the training of trainers in resilience.
- The army could identify no other competing entity.
- General Casey wanted the program expedited.
Army procurement and Penn negotiated for many months, and there was never any mention of past work that I might have done with DoD or Intelligence (I had not done any such work).
The only contract I ever held with the CIA or any other relevant group was in the early 1980s analyzing the speeches of world leaders for optimism and pessimism. Other than this, I have never before or since had a contract with any intelligence agency or any other relevant public or private agency. I have never held any security clearance.
ALMOST ALL THE criticisms came from people who opposed American foreign policy and our military interventions in the Middle East. So I must say two things in closing this chapter.
First, it is malice to invoke the Nuremberg Code, the Nazi doctors, and ethical violation in the criticism of CSF. Such allegations, however baseless, have a chilling effect on those many psychologists who want to help our soldiers and the government in these trying times. Some will wonder, Might I get accused of ethical violations? and so be deterred from service. I want to encourage scientists and mental health practitioners to come to the aid of our government, and I urge them not to let this tactic deter them.
Second, these critics accuse me of “blind patriotism.” My patriotism is not at all blind: I view the United States as the country that gave my relatives, persecuted unto death in Europe, a sanctuary where their children and grandchildren would flourish. I view the US 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 of my life.