Rabbi Block asked me to speak on the mental health of the deployed military personnel, well, that's about as easy to do as to summarize all of the interpretations that we might have on today's Torah portion. So I chose to tell you a little about my experience and what I have been told by others who were deployed, to hopefully give you a glimpse into the psychological impact of a modern deployment.

Many of you are here in uniform, and undoubtedly those who are not in uniform, know someone who has served in the military. Each of you may have heard other's stories or may have your own experiences with deployment and being part of the military. As a clinical psychologist my job is to help individuals when their behaviors, their thoughts, and/or their emotions interfere with their ability to do their job and/or live their lives in a functional and productive way.

We all know that by being part of the military incurs the risk of being deployed. But before Sept 11, 2001, deployments were rare for individuals in my career field, as well as for many career fields within the hospital. Before joining the Air Force, I spoke to many psychologists who said that in their entire 15- year career, that they had never been deployed. So when I came in to the Air Force 4 years ago, I didn't really expect that I would be deployed. Well, I was wrong!

On January 26, 2003 I found myself in the San Antonio airport tearfully saying good-bye to my wife Mary and two children, Alex who was 8 years old and Zach who was 2. I was accompanied by two others individuals from a squadron, a social worker, and a mental health technician. Only 5 days before had we been told that we were being deployed. We were like the other 250,000 service personnel who were being sent to the AOR around Iraq-we were going to a place we had never been, to do our jobs in a situation unlike any we had ever been exposed.

Anyone who has been around the military is familiar with the phrase “hurry up and wait,” that was certainly epitomized by the initial phases of our deployment. We were rushed onto a plane which took us to Dover AFB-and there we waited-in our desert combat uniforms in -20 degree weather!! It took 4 days before we found transportation eastward, only to get stuck in Germany for another four days. We were finally scheduled to catch a flight that would take us -just briefly through Kuwait (we had been trying to avoid going through Kuwait at all costs), where we told that we would quickly catch a flight to our final destination, except that when we arrived we found that there was no flight waiting for us, and we found ourourselves looking for a place to stay in the country where thousands of forces were amassing. In fact, the military bases were so full, that there wasn't room for us, so despite our attempts to avoid Kuwait--we found ourselves nervously staying in downtown Kuwait hotel. We ended up staying in Kuwait another 4 days before we could finally find a flight that would take us to our destination.

Once we finally arrived at our base we were faced with the daunting task of setting up our hospital, but after waiting almost 2 weeks, we only had a subset of the materials that we needed to set up the tents. We had the impending sense that the war would start soon, and that but we would not be prepared. Our behavioral health team set up a make-shift clinic and we started seeing individuals. In fact, within hours of our arrival we were consulting with multiple commanders and discussing several high risk cases, but now we were able to set up a place to see clients. Whether we were working at Wilford Hall, or working out of a tent in the desert-our job is the same. However, coming to see a psychologist can carry a stigma, and many individuals may be reluctant to seek out the services we could offer, so we find ourselves reaching out to others.

Many of clients that we saw were individuals who had had difficulties before they had ever left home. We saw other individuals who had been expecting to go home within days, as their 90 day deployment was nearing its end, however, just after our arrival, they had been told that their deployment was going to be extended-indefinitely.

Just when we had gotten into a grove and we had a feeling that we could manage the situation, I was told that I would be forward deployed-to a base that would be much closer to the action. After a two days journey I was able to make it to a base that was not exactly where I was supposed to be, but was about 30 miles away. So, I was escorted by two security forces personnel to my base. Throughout the drive the Staff Sergeant sitting in the back seat used my shoulder to help steady his M16. Each car we passed, or truck on the side of the road, was viewed as a potential threat. This was perhaps the closest I came to having some sense of what it must be like for the Marines and the Army soldiers, who today drive through the streets of Iraq, wondering whether the person they are passing are a friend or foe.

Once I safely found my way to my new location, I found a hospital that had a working ER with a surgery clinic, ICU, and a dental clinic. This hospital was up and running-just waiting for a stream of patients. The role of the base was unclear, but we guessed that we would be in a position to help care for refugees and we eagerly awaited an opportunity to be of assistance.

Once I safely found my way to my new location, I found a hospital that had a working ER with a surgery clinic, ICU, and a dental clinic. This hospital was up and running-all it needed was patients. For most of us our role that our base would play in the war was unclear. It seemed that we would be in a position to help care for refugees and we eagerly awaited an opportunity to be of assistance. Again, I set out to be available to those who were having difficulties.

On March 20th, the night that the war started, was the beginning of a 72 hour period when I had little sleep. In fact, I preferred to spend most of my time at the hospital, talking with others, using the internet to check the latest developments, but most all knowing that I would probably be safer in the hospital than anywhere else if a chemical attack were to occur. The construction of the tent was designed to protect us and allow us to do our jobs, even if chemical weapons had been used in our area. We were constantly reminded that at any moment our lives could change as we carried our gas masks everywhere we went and the roar of the fighters continued throughout the day and the night-certainly this was a time of extrodinary stress for everyone.

During times of stress we can often turn to our family and friends, but I was around strangers. Outside of a one week blackout period, I was able to email my family and let them know that I was OK and it was reassuring to here from them that they were okay too. Friends, family, and even temple members wrote to me showing their support-and every email brought a moment of joy and a temporary distraction from the ongoing war. While email certainly helped, nothing can replace the joy of getting a package, even if it is filled with your 10th bottle of sun block and your 30th stick of chap stick. But it wasn't just me who needed support, my family was certainly stressed by having me away in the middle of a war. At home my family received a tremendous amount of support from our friends and from our squadron-people who barely knew me, would meet with my family and others for a weekly dinner. It was this sense of community and outpouring of support, that helped my family tolerate this stressful period.

Data from individuals who were recently deployed not only with Air Force units, but also with the Army, suggest that 80% of the individuals who are being seen by behavioral health professionals, were experiencing difficulties with marital problems, anxiety/stress symptoms, work problems, depressive symptoms, or problems with anger.

When we experience stress and strain we can experience a range of physiological symptoms, such as muscle tension increased heart rates, sweating. We may experience a range of emotions, from sadness, to anxiety, to anger. We may not sleep well, we may worry or become fearful.

Although all of my trials and tribulations related to traveling were distressing, and although during the first 2 weeks of the war, we laid awake wondering when the chemical attack would occur, at no time were we actually shot at, at no time did I come close to death, or see others dying.

Of 82 people who were seen by behavioral health providers in Iraq after the war, 37% said that they had seen someone wounded, killed, or dead, and 39% said that at some point during the deployment they felt that they were in great danger of being killed.

To say that deployment is stressful, hardly seems to capture the emotional complexity such a disruptive event. Deployment right now often means that an individual is going into a situation where it is difficult to predict what will happen from one day to the next and that individual has little control over how they spend their time. By definition, decreased ability to predict what will happen, decreased perceived control, and a high level of demand defines the word stress.

It is impossible for us to understand or know the thoughts of the Marines, Soldiers, Seamen, and Airmen, who are on the ground and on the water, who everyday have little control on how they spend their time and can not predict who is their friend and who is their foe, and do not know when they will see their family and friends again. The behavioral, emotional, and physical strain is unthinkable-some learn to adapt to this strain-others do not--or act in ways that they would never consider acting outside of a wartime situation.

I was lucky-I came home 3 months earlier than I thought. We never did see any refugees at my second location. But as I was leaving I experienced one of the more moving parts of my mission, I found out the role that the thousands of personnel who served with me were doing at my second location-our primary goal to protect Israel from any attacks-which we seemed to have done quite well.

Even coming home, although a tremendously joyful experience, was also a time for readjustment, acclimation, and stress. Time does not stand still-and just as a deployment changes the individual who is being deployed-the family at home changes as well-as they have had their own deployment-experiencing life without their parent or spouse who in the past had been available to help with all of the daily tasks of life. When joined together again they must all figure out how they will fit back together again.

So as we celebrate our freedom and our armed forces on this July 4th, I encourage you to reach out to those individuals who are deployed and their families. Consider taking the time to send postcard, a letter, or even another bottle of suntan lotion or stick of chap stick to someone who is deployed or take the time to make a meal or offer to baby-sit for a family who has someone deployed. Whatever you can do, to help support or even briefly distract, a military member or their family from the stress of deployment is time when they may feel a bit more at ease and a perhaps briefly more at peace.

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