I am a missionary of prevention from the psychologically injured Vietnam combat veterans that I’ve worked with for the last ten years. They don’t want other American kids to be wrecked the way they were wrecked, and are bursting with pride that their words are being heard inside the Armed Forces. Working with them, I came to three conclusions about the keys to preventing psychological injury. These are all in the hands of military line leaders and trainers:

• Positive qualities of community of the service member’s face-to-face unit (cohesion)
• Training that works for what troops really have to do and face
• Competent and ethical leadership

Absence of these key things has devastated these veterans’ lives, because it destroyed their capacity for trust; and our clinical work all aims at restoring the capacity for trust. What I did not know at the time I drew these conclusions in the clinic, and which I now know, is that trust and trustworthiness are the essential lubrication that overcomes what von Clausewitz called the "friction" of military operations. Military people tell me that the three things I have identified as reducing psychological injury are each powerful combat strength multipliers.

Now nothing I say here today on prevention is new to military psychiatry. The history behind the things I advocate is laid out in the two volumes on psychiatry in the Army Surgeon General’s new edition of the official Textbook of Military Medicine and distilled into doctrine in the Army Field Manual 22-51, Leader’s Manual for Combat Stress Control.

The power of the three keys to preventing psychological injury lies in the trust and trustworthiness that they produce. What I have to say to you is that the prevention of moral and psychological injury in military service mainly boils down to the preservation of trust. My object here is to show how this is the case.

Cohesion

One Marine veteran I work with recently said, "Either you’re covering my back or you endanger my life!" Patrolling in enemy countryside pushes things to this black and white extreme. He wanted to protect his buddies’ backs and he wanted to be confident that they would cover his. He wanted to trust and be trusted by his comrades.

To have a face-to-face community of comrades whom you trust in harsh, dangerous, often extremely deprived circumstances has momentous psychological and even physiological consequences. When terrible things happen—and you survive—the continued support from others in a community of mutual trust is critical to psychological and spiritual healing.

So what are ingredients of this kind of unit?

• Members have the raw competence to perform the military tasks
• Members have the confidence that comes from having practiced these things together and gotten through things together
• From plan or accident, the members of the unit have stayed together psychologically and physically through training, into danger, and back out again

Ethics, leadership, and policy should converge in supporting small unit cohesion, but often they do not. Trust, trustworthiness, and a sense of belonging are rarely even seen as the ethical goods that they are, because they are so hard to package in the legalisms and moralisms that have come to dominate ethical discourse, especially in the military. They are actually not all that difficult to measure, as long as the content of the measurement does not become part of the practiced "looking good" culture of the leadership that often pervades military units. Unit members can be coached and coerced into responding to cohesion questionnaires and interviews in a ways that get the unit a high cohesion score, regardless of the actual state of human relations in the unit. But personnel turbulence is easy to measure, and is much affected by policy.

Where leaders are successful in training for cohesion, they find themselves stretched as never before by their subordinates to provide more challenging, demanding, and interesting training situations. This is cause for celebration in itself, and for the motivation it provides for leaders’ self-improvement. Cohesive units do not need to be flogged to achieve excellence—they drive their leaders forward. The Army’s abandoned COHORT [Cohesion, Operational Readiness Training] created new combat arms companies that kept the same soldiers together through basic training and linked them with their direct leaders in AIT. The COHORT program then kept the personnel in the company or platoon together (as much as possible) throughout the first enlistment. This maximized horizontal bonding and first level of vertical bonding. COHORT companies quickly reached a higher level of proficiency than units manned by the individual replacement system, and kept improving throughout the three-year life of the units. They scored high on measures of cohesion. However, they also demanded much more of their leaders in the way of competence, confidence, and commitment.

Personnel policies that treat service members as replaceable parts and promote turnover in units are profoundly destructive of cohesion. When a new carburetor is put in a car, the brake shoes don’t need to "get to know" it or to practice starting and stopping with the new part. The apparent administrative rationality that makes interchangeable any service members with identical MOS and similar training credentials is blind to the social and psychological significance of trust. The new 11Bravo brought by helicopter from the replacement center to a highly stressed unit on a hilltop surrounded by the enemy somewhere in Vietnam, was not equivalent to the 11Bravo who left to get ready to DEROS. The consistent recommendation of military psychiatrists on rotation and replacement policy to prevent battle fatigue casualties, to prevent military and civilian-directed misconduct, and to reduce post-combat mental disorder has been to rotate and replace by unit, not by individual.

However, during World War I, the United States Army went to individual replacement of casualties, and during the Korean War went to fixed-length tours. Individual replacement of casualties is now so long established that many in the United States Armed Forces cannot even imagine that there is an alternative. But there is, and the alternative of unit replacement and rotation has been practiced continuously by other armies. When a unit has suffered serious attrition it is replaced by another unit and withdrawn to re-equip, integrate new personnel, and retrain—and then put back in the fight. When rotation is called for, the whole unit is rotated.

The civilian DoD personnel and serving officers who perpetuate the individual replacement and rotation system are mainly doing what they understand to be right and rational. They do what is taught in business schools and schools of public administration as being administratively and economically efficient. It is a "management science" approach which may (or may not) be optimum for an enterprise like digging copper ore from a mountain, or laying water pipe in city streets. Neither the mountain nor the city street is an intelligent, observant, self-sacrificing enemy who reacts to what is done—and counterattacks. As von Clausewitz said more than a century and a half ago:

The laws that von Clausewitz refers to are the laws of Newtonian mechanics that commanded dominating prestige in his day. The sophisticated managers in the armed forces today would snicker at such a naive notion of military science—at the same time as they fall into the same error. For the science of mechanics in von Clausewitz's day, substitute the prestige of "management science" today.

There have been periods in every service when extraordinary amounts of leadership energy have been occupied with detecting and punishing misconduct. The astonishing rise in the quality of recruits over the last ten years has greatly ameliorated this. One easy response to any misconduct is to call for more detailed rules, closer surveillance of behavior from above, additional documentation, and harsher punishments. But these reactions actually weaken vertical cohesion and degrade its power to prevent misconduct.  Unit pride leads to mutual governance at any echelon. In a cohesive unit, when criminal or improper conduct is displayed or proposed, it is met with the pride-filled group sanction: "WE don’t do that!" An Army research study measuring cohesion in 20 battalions of the 7^th Corps in the late ‘70s found that the incidence of criminal misconduct in five most cohesive battalions was only one-third the rate in the five least cohesive battalions.

Similarly, a great deal of leadership energy goes into reacting to attempted and completed suicides and into improving rates of reenlistment. Suicide prevention and reenlistment would seem to be utterly disparate matters—very odd to be mentioned in the same sentence—but they are both beneficiaries of cohesion. In cohesive units the mutual care soldiers give each other is an effective antidote to depression, and it creates a sense of belonging that soldiers do not want to give up by quitting the service. The same Army study cited above found that the five most cohesive units averaged about 150% of their assigned quotas for re-enlistment, while the five least cohesive averaged about 80%.

Training

It may seem odd at an ethics conference to focus on training, unless I’m going to talk about hot-button issues like sexual exploitation of trainees. But the stakes in military action are mortal. If raw competence, both technical and leadership competence, is not an ethical concern where the stakes are so high, then young captains preparing to be company commanders are right in ridiculing lectures in ethics as irrelevant. In terms of my own agenda to prevent psychological casualties, I have come to appreciate as simple truth that achieving operational success and avoiding catastrophic operational failure prevent all sorts of casualties, both physical and psychological. For this, competence is a moral imperative in military operations, from the lowest tactical level of siting weapons and wire to the highest levels of operations and strategy. When faced with the real thing, military competence is life-saving and soul-saving.

Professional ignorance is the mortal enemy of command integrity. When a senior officer does not know what to do, he or she is embarrassed. The temptation, so readily yielded to, is to use bluff and lies and to place undue emphasis on matters the officer does understand, to cover ignorance. This is at the root of what used to be the profoundly corrupting ritual known as the "annual general inspection" under the IG system. The chief of the inspection team would typically introduce his team with words such as, "We are here to see if you can accomplish your mission." The team then proceeded to a minute inspection of the magazines in the dayroom, unit punishment records, mess hall accounts, and the uniformity of displays of individual field equipment that was never taken to the field. They inspected everything that had nothing to do with the mission, and nothing that had anything to do with the mission. The reason was that the inspectors understood nothing about the mission, so they inspected what they did understand, and then passed judgment on the unit. That form of inspection was devoid of integrity, and it required the members of the inspected units to divert energy from becoming competent. It put a premium on the ability to fake their way through. If you back an honest person into a corner and apply enough pressure, he or she will lie.

One of the bitterest sources of betrayal experienced by the veterans I work with comes among those who found that their training did not prepare them for what they actually had to do and to face. What could be less controversial than training for competence? Where’s the ethical issue?

In many of our training centers and units, the military culture puts leaders with integrity under harsh moral strain. There are enormous pressures to devote time and energy to things that merely look good, but which do not genuinely contribute to the growth of competence. There are pressures to get along and go along. To honestly point out deficiencies in training resources can make a leader’s boss uncomfortable; to insist that the lack of these resources be drawn to the attention of higher echelons can be fatal to that leader’s hopes for advancement. For example, where service members’ lives depend on the functioning of System B, but the school only offers training on obsolete System A, the training does not create competence. The trainers must get the equipment. It is an ethical imperative. When integrity is part of the military culture, it is supportive, invigorating, and comforting.

Or the resources may be in the form of time. Training to competence is prolonged. Barring revolutionary breakthroughs in the physiology and pharmacology of learning, all training requires adequate time for it to become consolidated and settled into the skills, perceptions, habits, and reflexes of the trainees. Officers who accept cuts in training time that they know to impair final competence are lying to their trainees and to their superiors.

Or the resources may be in the form of personnel. In many units and training centers those who do the teaching never get anything approaching adequate sleep. Sleep deprivation destroys self-control, balance, and social judgement. Sleep-deprived instructors will predictably misbehave in a multitude of ways that multiplying new rules and redoubling punishments can never cure. The cognitive and social judgments required of trainers to recognize the line between training and torture, to recognize when necessary toughness of training conditions has gone over the line into callous disregard for safety, require them to be socially supported and neurologically fit. Basic brain fitness starts with getting enough sleep. Training must be tough and realistic enough for service members not to freeze or run in real danger (i.e., they must receive "state-dependent learning"), but not so dangerous that lives and limbs are lost needlessly. If leaders or instructors are exploited and chronically sleep-deprived because of inadequate staffing, they will lack the enthusiasm and energy to stay with the students until they get it. Down the line in combat, people will die because they didn’t get it.

The training leader who makes him- or herself noticeable by insisting on the necessary resources for the school may become very unpopular with superiors and peers. Facing this kind of moral strain should be considered part of the training of every officer, commissioned and noncommissioned. The higher an officer goes the more the balance shifts from physical danger to moral danger. Do our personnel systems reward moral courage in the same way they reward physical courage?

I hope you can see the central point I am aiming at: ethics, leadership, and policy converge on trustworthiness. Whether they use the words or not, service members ask, "Can I trust the service to give me training that will prepare me for what I have to do? Are my trainers giving me the straight story? Can I trust myself to know what to do and to do it when the chips are down?" Knowing your stuff is not enough to produce confidence—you’ve got to know you know it and know it’s the right stuff for what you’re getting into.

Command Climate

Vertical cohesion comes in part from esprit and loyalty that attach to the larger unit, service, and nation, but mainly from trust in immediate leaders. Unlike in civilian institutions, where lateral moves at virtually any age and level are common, almost everyone enters the Armed Forces at a young age. When things are as they should be, the service is a community of older and younger members who relate to each other with trust, respect, and the well-founded expectation of mutual help. Nothing destroys trust in the chain of command so quickly as a leader’s exploitation of institutional power to coerce from subordinates a private gain, be it sexual, financial, or careerist. Of these, careerist exploitation is the most frequent and the most damaging. The whole unit—sometimes the whole service—is injured. There are no private wrongs in the abuse of military authority. The target of the abuse of power is not alone in being injured. Of course that service member’s trust in the chain of command is going to be impaired or destroyed, but in addition, all that have knowledge of it also suffer injury to their capacity for social trust. The competence, consideration, and moral integrity with which leaders deploy institutional power are the core constituents of vertical cohesion. Everyone is always watching the trustworthiness of those who wield power; and this "fishbowl factor" is more far-reaching than most people think.

The phrase, "command climate," has no settled meaning. Some have used it to refer to the atmospherics in the unit or the weather report for the boss’s immediate neighborhood, as in what’s the boss’s mood, "stormy" or "fair." A widespread and useful definition is simply a unit’s atmosphere of support, cofidence, and cohesion (or their opposites) created by commander’s acts and example. But how a service member’s leader applies power to that service member is only half the story. The other half is how leaders treat each other—do they trust each other and communicate candidly? In my view, a neglected dimension of command climate is the social and ethical ecology of power above one’s own position.

You can see that I am broadening the term command climate to include matters that are "none of your business." If you’re the platoon sergeant, it’s "none of your business" whether the captain trusts the colonel and vice versa. In peacetime, in garrison, these matters are subjects for gossip and lots of stress—but in war they become matters of life and death. If the captain is lying to the colonel for fear of the boss’s reaction to the truth, that may be deplorable in garrison, but in war people die from it. Military field exercises are and must be potentially dangerous. In some training settings in peacetime, a leader who makes it unsafe for subordinates to tell the truth can be lethal, too. In any high stakes situation, those in a subordinate position are shaped by whether or not those in power above them trust each other, even when apparently it’s "none of the subordinate’s business." The most powerful teaching medium available to the armed services is the example set by leaders in their behavior toward each other in the echelons above, as well as toward a given service member or group of them. This is command climate, as I suggest that the term be used.

Character is fluid throughout life. It is imitative throughout life. In high stakes situations, people learn about the use of power from the ways power is actually used in their environment, even if they are not "directly involved."  Over time—sometimes only a very short time—it is the example that is set in action that governs what people actually learn in these areas. Moral learning continues throughout life.

Because of a range of community, workplace, and family changes leading to less adult investment in the young, the current generation of young people comes to military service on the average, with less "social trust." That is, they have less capacity to trust leaders on the basis of their credentials and institutional position, are less able to sustain ideals, ambitions, and positive social identifications in the face of betrayal of "what’s right." However, as we learned to our sorrow in the Vietnam era, no young person, no matter how fortunate, comes to the service with a limitless bank account of "social trust." I believe that  the very same positive leadership and training practices that prevent damage to the "social trust" of the fortunate, also provide remediation to those who have suffered family and community disintegration. They are the same for both prevention and remediation.

Last year at JSCOPE I gave the hideous example of an artillery battery captain degrading his lieutenant before the whole battery during a force-on-force exercise, and described the catastrophic operational failure that ensued. On a cheerier note this year I shall attempt to summarize positive leadership practices that create good command climate. Seniors create a positive command climate when they do the following with respect to subordinate officers and NCOs:

• Support subordinate leaders’ professional growth
• Trust them and work hard to assure their success
• Assign missions without prescribing the means to accomplish them
• Provide situations in which subordinate leaders practice what they’ve learned
• Build their competence to assess situations and take the initiative to develop adaptive solutions
• Mentor, rather than intimidate subordinate leaders
• Refrain from meddling in their spheres of responsibility
• Require subordinate leaders to study their profession
• Take responsibility for setting mission and priorities; not assign every task as "highest priority, to be done immediately."
• Listen to subordinate leaders’ feedback on time-budgets and resources
• Support realistic time-management, rather than defeat it
• Make it safe to tell the truth
• Support self-maintenance, rather than defeat it
• Support subordinates’ families

This cluster of leadership practices has been called various things at various times and places: Auftragstaktik,  "Power Down," empowerment, decentralization, and others. A full discussion of this subject is far beyond the scope of this paper. I shall briefly expand on the last three items in the above bullet list.

Make it safe to tell the truth

In military organizations, the core reason for truth-telling is the maintenance of trust, both upward and downward in the chain of command. In the long run, neither punitive sanctions, nor the Ten Commandments, nor the very finest system for selecting officers for good character can guarantee consistent truthfulness. Consistent, reliable truth-telling is only possible when power is deployed in such a way that it is safe to tell the truth. Only then do subordinates feel safe airing their doubts and problems, telling bad news, owning up to failures. This is not coddling, because truthfulness in leadership calls for vigorous critiques. The trust created by the practices of Auftragstaktik is the main reason they are combat multipliers, while mistrust among peers and along the chain of command is a potent self-generated source of Clausewitzian "friction." Leadership truthfulness at all levels means e liminating perverse incentives to look good at the expense of being good. This is where personnel evaluation and promotion policy have got to converge with ethics and good leadership practices, but so far every attempt to reform this policy area has gone on the rocks.

The "unit readiness report" is another practice laced with institutionalized fraud. Its ostensible purpose is to inform top management of the readiness of units so they can take appropriate action to provide the unit with resources to overcome readiness deficiencies. It is also intended to permit the top leaders to intelligently advise the National Command Authority about what is really possible against future or present threats, or to carry out particular national purposes. I suspect that much of the trouble starts at the top where the service chiefs learn that it is not safe to tell the truth to their civilian bosses in the executive and the legislature, and simply say "Can do, Sir!" Their subordinate commanders learn by example, and they experience perverse incentives to report the highest readiness rating, irrespective of the actual condition of their commands. At each lower echelon, each officer feels the pressure from all the commanders above, who will look bad if one of the units under them reports a low readiness condition. So in the weeks prior to submission of the reports, middle-rank commanders assemble their subordinate commanders and have them transfer, on paper, personnel and equipment so that according to their records, every unit is at the highest possible state of readiness. Top management is pleased with this arrangement, because with all units at high states of readiness, they do not have to make any hard choices, or endure the moral dangers and do the work needed to support and strengthen their units. These exercises in deceit divert a great deal of time from real missions, create a climate of unethical conduct, discredit the integrity of senior commanders, and denigrate the devotion and labor that has gone into the actual readiness of the reporting units.

Support self-maintenance

Maxim: "In order for me to do my job, I need to know you are taking care of yourself." A climate of competitive self-denial among subordinate leaders to demonstrate "motivation" or good "attitude" creates dangerous conditions through neglect of health care and through sleep deprivation. The "motivation" and "attitude" that we need, comprise focus on mission and the well being of the troops—both of which require junior leaders who perform preventive maintenance on themselves.  A good leadership climate supports their self-maintenance, particularly sleep discipline. Neither junior leaders nor their bosses should ever allow themselves to become physically or emotionally exhausted. It is the ethical duty of commanders to see that their subordinate leaders never lose leave.

Support subordinates’ families

If command supports the family, the family supports the service member in his or her participation and commitment to it. This simple truth is often ignored at the price of poor retention, family violence and breakup, and corrosive distraction on the job. This is a large subject about which I can only offer a bulleted summary here—

• Provide maximally predictable off-duty time, protected from arbitrary call-backs
• Honor comp. time commitments
• Provide logistical and administrative support to family support groups and create a positive family-unit culture
• Provide prompt, complete, candid information to families
• Promote mutually supporting networks of spouses who can help each other overcome worries and control rumors
• Foster family support networks that avoid compulsion, formality, rank structure and hierarchy, that function face-to-face and promote real friendships

Conclusion

Confidence and trust are simply different colors in the same beam of light. At any echelon, if you know your stuff—that’s training again—and you know the troops serving with you—that’s cohesion again—and know your boss is devoted to your success and well-being and will not abandon you—that’s leadership again—then you really have confidence. Courage and commitment come along with that kind of confidence like fingers on a hand. Military researchers have been telling us for more than a century that cohesion, training, and excellent leadership are each combat multipliers. Military psychiatrists have been telling us at least since World War I, that these can prevent some (not all) of the life-long symptoms that can follow prolonged heavy combat. I want to add to this my belief that they can prevent, perhaps absolutely—I don’t know this for sure—the damage to the capacity for social trust that wrecks veterans lives, that destroys their families, that disrupts their workplaces, and in the extreme, that threatens democratic institutions. So the ethical, leadership, and policy concepts described here are win-win for the service, for service members, and for the nation. The veterans I speak for say: Do it!

ACKNOWLEDGEMENTS: I am grateful to the chairman, General William Richardson, and to my fellow panelist, Major Richard Hooker, for their critical feedback on earlier drafts of this paper, and particularly to Faris Kirkland, Ph.D. (LTC, USA, retired) for vigorous critique and permission to paraphrase unpublished material.

ENDNOTES

The views expressed here are the author's own, and should not be taken as an official position on any matter by the Department of Veterans Affairs. Jones, Franklin D. et al. War Psychiatry, 1995, particularly Chapters 1 - 3, 5 - 7, 10 - 12, 19; and Jones, Franklin D. et al. Military Psychiatry, 1994, particularly Chapters 1,3, 9, 10, 11, 13. Both volumes are part of the Textbook of Military Medicine, Part I. Office of the Surgeon General, United States Army. Promulgated by the Army 29 September 1994, and available on the World Wide Web at URL http://www.acs.amedd.army.mil/DCDD/22-51/ Manning FJ and Ingraham LH, "An Investigation into the Value of Unit Cohesion in Peacetime." In: Contemporary Studies in Combat Psychiatry, edited by G Belenky. New York, Greenwood Press, 1987 Kirkland FR, Teitelbaum JM, Ingraham LH, Caine BT. Unit Manning System Field Evaluation, Technical Report No. 5. Washington DC: Walter Reed Army Institute of Research, 1987. Hooker RD., Jr., "Building Unbreakable Units," US Army Military Review 75:24ff (1995) Carl von Clausewitz, On War. Indexed edition. Edited and translated by Michael Howard and Peter Paret. Princeton, Princeton University Press, 1984. Page 149, emphasis in original. Manning FJ and Ingraham LH, op.cit. p 59 & 65. Specifically, "The number of apprehensions by local military police of battalion members for all crimes during the previous twelve months." I am not talking here about inspections by organic line commanders, who do understand the mission. Both the benefits from these practices and the catastrophic consequences of the familiar rule-by-fear and manage-in-detail-from-the-top alternatives are lucidly documented in Faris Kirkland's (LTC, USA, retired) publications in professional military journals and textbooks, a partial selection of which is as follows: Kirkland FR, "The Gap Between Leadership Policy and Practice: A Historical Perspective." Parameters: US Army War College Quarterly 20(3):50ff(1990) _________, "Combat Leadership Styles: Empowerment versus Authoritarianism" Parameters: US Army War College Quarterly 20(4):61ff(1990) ________, "Soldiers and Marines at Chosin Reservoir: Criteria for Assignment to Combat Command." Armed Forces and Society 19:257ff(1996) Kirkland FR and Katz P, "Combat Readiness and the Army Family." US Army Military Review 69:63ff (1989)