CAMP AL ASAD, Iraq -- Navy doctors in Iraq are fighting an enemy just as debilitating as hostile fire.
It's called combat stress and measures taken to reduce the effect of combat stress on today's Marines in Iraq are unlike that of any previous campaign.
Essentially, Marines should expect to encounter two types of extreme stresses in Iraq, said Navy Lt. Cmdr. Gary B. Hoyt, a psychologist for Regimental Combat Team 7. They are combat and operational stresses and occur when Marine and sailors are exposed to prolonged deployments.
According to Hoyt, stress is defined as events, which interfere with the body and mind's attempts to maintain normalcy.
"There are generally two types of deployment stressors, " said Hoyt, from Carlsbad, Calif. "You have combat stress, which normally affects your front-line infantry units and then operational stress which is an artifact of cumulative or prolonged operational demands."
In plain and simple English, combat stress is a sudden, extraordinary event or prolonged events that takes a toll on a person's mind and body. Operational stress is built-up stress over a long-term deployment, normally a combination of events.
The deployment to Iraq, with quick burst of fire and drawn-out days patrolling in the desert sun, is a breeding ground for both types of stress. The trick isn't to remove the Marine from the source of stress, but get him to deal with that stress in a constructive manner.
So far, the program seems to be working.
"Doc normally sees between four and five people a day," said Navy Petty Officer 2nd Class Seaver E. Leisinger, a psychological technician with the regiment from Grand Terrace, Calif. "He's very successful, he's sent home maybe two people out of over 60 he's seen."
Hoyt and his assistant, Leisinger, are a part of the Operational Stress Control and Readiness (OSCAR) program, a pioneer effort that attaches a forward-deployed psychologist to a Regimental Combat Team. The dual emphasis is to bolster Marine combat effectiveness and minimize psychiatric difficulties after the deployment
"The purpose of this program is to retain as many Marines and sailors in combat-effective roles as possible," Hoyt said, "while providing for their mental health needs here in theater."
That differs from past methods.
"Before they had to ship them back to the 'states,'" Leisinger said. "Now we can fix the problem while here and not lose anyone."
The two-man team travels the regiment giving combat and operational stress briefs, providing consultation to commanders and treating patients.
"We travel a lot," Leisinger said. "But, it's all worth it. If one person comes back and says thanks then at least we know we've made a difference."
Combat casualties and problems on the home front are the major sources of stress while deployed to Iraq, Hoyt explained. That's especially true as Marines and sailors see comrades killed.
"They may be wondering what the point is of someone dying in a dark alley far, far away from home," Hoyt said. "They need to be reaffirmed of their mission conviction and given a framework for the death of a fellow Marine or sailor. The Marines that I have observed and their leadership have been exceptionally professional and inspiring during these incidents."
Lt. Col. Phil Skuta, commander for 2nd Battalion, 7th Marine Regiment saw signs that combat and operational stress were taking a toll on his Marines. He called for Hoyt and Leisinger to come speak to his Marines.
"It's going on four months now," Skuta said. "I can see people becoming stressed. I can see it in myself. Having stress is a normal thing, something we shouldn't feel bad about. We would be kidding ourselves if we thought we were invincible to it."
Skuta said he's seen units overcome with stress and the effect was the unit becoming ineffective. He also said it's important to slowly release most of that pent up stress before going home.
"We need to learn out here how to slowly rid ourselves of stress," Skuta said. "Once we go home we don't want to see the problems historically associated with going from combat to non-combat roles. It all adds up and if we don't learn to release it now we may have a lot of problems when we get back."
Leadership is the number one factor that in identifying and coping with stress, Hoyt explained. Good leadership is also the best way to prevent it if possible.
"You have to know your Marines," he said. "A shift in how someone conducts himself is how you tell when something is wrong. Everyone has unique stressors, unique experiences and unique coping skills. If you don't know them you can't help efficiently."
Keeping the Marine within their unit is also a key factor with coping with stress.
"People respond with far greater resilience and courage when they feel they are a part of something bigger than themselves," Hoyt added.
Hoyt suggested talking to Marines and clarifying the purpose for their mission to give them measures to counter the build-up of stress. He added that it's important for Marines to know what the measures of progress. A sense of control and predictability is vital.
"They don't always need to know everything, but they shouldn't be left in the dark," he said. "It is easy to be intimidating, but a true leader inspires."
If a problem arises the command should take immediate action, according to Hoyt. Battalion aid stations have representative who can get help and provide ways to combat the situation. They can also refer Marines and sailors to a psychologist if the problem is serious enough.
"Often the chaplain, (noncommissioned officer) leadership, or medical are great people to see first," Hoyt said. "Sometimes we just need someone to talk to."
Chaplains have some experience in psychological matters and are often times able to help solve the problem, but may also refer a servicememeber to a psychologist if needed.
Leisinger said activities such as physical exercise have been proven to greatly reduce stress. Also taking time for oneself is a great way to keep stress down. Reading a book or watching a movie can go a long way.