By Mary Markos
Special to American Forces Press Service
Sept. 2, 2009 - Army Capt. Emily Stehr, a physical therapist with the 2nd Stryker Cavalry Regiment, is in the business of healing. But five months after returning from Iraq, she was struggling with her own internal wounds of war that had not healed. She decided to kill herself. What stopped Stehr was not the physical pain she would have endured, but the realization of the emotional pain she would inflict on the children of her close friends when their parents would tell them, "Aunt Emily in not around because she killed herself."
"I was not willing to put that pain on those children," Stehr said. "I'd inflict the pain on my mom, my dad, all my other loved ones; but those kids, I can't do it."
What Stehr did was check into Landstuhl Regional Medical Center and begin the process of healing.
"I like to think of [suicide] like cancer," she said. "I did not even know I was sick. I just kept waiting for me to return to normal, and it never happened. Stuff kept escalating until it was either, I'll be dead or I'll get treatment.
"Looking back," she continued, "I can see the whole process, but when you're going through something like that, you're so blind because you're in your shell."
Part of her healing process was coming out of her shell and finding what she called the "tumor," or reason for her emotional pain and suicidal thoughts.
"I had to go back and root out what was causing the maladaptive behavior, the tumor," she said. "Ultimately, unless you deal with that, it's always going to plague you. You have to deal with it head-on."
Dealing with the cause of her suicidal ideas meant dealing with the anger, grief and emotional pain Stehr said she felt after returning from Iraq.
"For me, it was an accumulative trauma - watching patients die," Stehr said. "I had a patient kill himself. We lost 33 people when we were down there. It is hard to see again and again and again. ... In my mind, I never really left Iraq."
Part of her struggle to return to her "pre-deployment" self, she said, included overcoming the stigma associated with seeking mental health care and discussing suicide.
"Nobody really wants to talk about suicide. People don't know what to say," Stehr said. "There's shame [and] embarrassment. I really thought that I was weak. I bought into the whole stigma that people who are suicidal or have mental issues are weak."
Army leaders have acknowledged the stigma associated with seeking mental health treatment and have taken steps to combat that stigma as well as suicide in the service's ranks.
Although the number of suicides in the U.S. Army Europe rose from four in 2007 to seven in 2008, the effects of the Army's efforts to eliminate the stigma of seeking treatment were evident in an informal poll taken Aug. 25 at U.S. Army Garrison Grafenwoehr.
Of nearly 60 soldiers polled, 51 percent said there no longer is a stigma associated with seeking help, and 62 percent said those who seek mental help are not seen as weak. At least one soldier attributed this to "the change in Army culture."
It is a change that starts with the leadership, said Col. James Blackburn, commander of the 2nd Striker Cavalry Regiment. "Fundamentally, as leaders, we have to recognize there's a challenge, and in this case the challenge is cultural," he said. "We are in the profession of change, changing the culture."
With the cultural change, Blackburn and and other regiment leaders supported Stehr in her decision to talk to others about her suicidal thoughts.
"I strongly feel Emily's brave move to share her story with the public is exactly what the Army needs to decrease the stigma associated with seeking help," Blackburn said. "By stepping forward, she is showing other solders they are not alone, and it is OK to talk about what is troubling them.
"We've got to make people understand," he continued. "Scars -- you've got them, I've got them, we've all got them. Some are visible. Some are not visible. Everybody deserves a chance to be successful. Part of that is tearing down the stigma associated with any illness, any scar, that you incur while in the Army, or even before you came in. You are ours now, and we will put you in a position to be successful."
Talking about mental illness and suicide is the only way to prevent others from taking their lives, Stehr said.
"It has nothing to do with being strong or being weak; you're sick," she said. "The correct philosophy is that you're a human, and sometimes crap happens, and you have pain. But you need to deal with your pain. Get help when you need it. Take care of yourself emotionally, mentally, psychologically. It's going to make you a better soldier."
Blackburn agreed, saying soldiers who seek help "are strong."
"They're strong because they are able to examine themselves and know there's something wrong," he said. "Most people generally don't say, 'I have a problem.' And this population of our soldiers [is] strong because they have the fortitude to do a self-examination, and they know the result. They don't conceal it, they let it out. That's a strong population, not a weak one."
To stay strong, Stehr said, all soldiers need to offer support and be willing to listen and talk. But, she said, it is not as easy as just asking people if they are going to hurt themselves.
"It is never that easy. There is no 'easy' about any of this," she said. "Encourage that person, and be there for them. The more we talk about it, the better off we are."
Blackburn encourages soldiers to reach out and get the help they need. "If you are hurting in some way, if something's on your heart, or something's on your mind, reach out.
"If you hold it in, it won't do you any good," he added. "It won't do your immediate family any good. It won't do your extended family any good. And it certainly won't do your battle buddy any good. We are here to help you."
(Mary Markos works in the U.S. Army Garrison Grafenwoehr public affairs office.)
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