IN EASTERN SAUDI ARABIA — The overwrought airman insisted that he didn't need a psychologist. He just wanted to go home because his wife needed surgery.

"He wouldn't get off that for about five minutes," said Maj. Phil Colosimo, an Air Force psychologist working in Saudi Arabia. "He said, 'She's going to have surgery, and I'm afraid it's going to be bad.' "

First, Colosimo arranged for a flight surgeon to explain the surgical procedure an how the airman's wife was going to come through all right because her condition had been detected early. "Then we talked to him about how he could work with her on the telephone and talk things through with her.

"He did that, and the next day he came back and he was a new person. He was very settled, his anxiety had gone away, and his wife said she was doing fine."

For Colosimo and other psychologists, Operation Desert Shield is a daily battle in which. the enemy is stress, anxiety and fatigue, and the casualty rate can he measured by a unit's morale and its ability to maintain battle readiness.

At one Air Force base in eastern Saudi Arabia, a large tent has been transformed into a drop-in stress management center for people who want to discuss problems. There are also periodic classes on stress, coping skills, and relaxation training.

"Our goal is to ... keep the troops ready for any type of thing that might happen here. We also want to try to keep everybody in the theater ready to function at their maximum readiness condition. Medical readiness is a very big thing for us," said Colosimo, 42, the chief of mental health services at Nellis AFB, Nev.

One of the tasks is overcoming the reluctance of some commanders and supervisors to discuss the stress involved with desert duty. Military psychologists in the gulf report that high levels of stress are to be expected in a deployment to a potential battle zone.

Probably the biggest source of stress is the separation of families. "The thing we say to people over and over is you have to live here," said Lt. Col. Dick Price, who works with Colosimo. "If their body is here and their heart and soul and everything else is back there, it's much more difficult. So we encourage people to sort of adopt a family here," said Price, the chief of mental health services at England AFB, La.

'The buddy system is OK, but you also need, a group of friends and activities so you're not just pining away all the time and feeling so inadequate."

Long hours of work, changes in climate and culture, tedium and uncertainty about the future can affect the mental health of soldiers.

Since there is no way to remove the stress, the psychologists try to improve the ways the troops handle it. The worst thing anyone can do is to try to avoid the topic, they said.

In general, servicemembers that look on the deployment as a challenge rather than a threat have an easier adjustment. "People differ incredibly in terms of the way they respond to stress," Price said. "Your own background ... what you expect to happen, your values, assumptions, predictions, all factor into how you handle the stress here."

The psychologists said that much of their work is aimed at helping commanders and supervisors to be more sensitive to signs of stress in their troops. "The first line of defense in stress management is with command, and the way procedures are implemented and the way they manage people," Price said. "It's not really a mental health issue, it's a command issue."

To that end, the mental health experts have been briefing unit commanders and other leaders on how to recognize signs of mood changes among their troops. "Maybe some people aren't sleeping quite as well, maybe some people are missing their meals," he said. The first sergeant, the commander, the supervisor, the dorm mate who notice that these people aren't quite doing these things, can be a big help to these people."

Stress management classes, aimed at making the troops feel like they have more control over their lives, have become more popular as the deployment stretches into three months.

"If you feel that your environment is going to dictate what your emotions will be, then that's going to make it a lot harder and you're going to feel like a puppet or a victim," Price said. "We try to encourage folks to recapture a little control over how they're going to feel, even if the situation is not quite what they like."

In war, psychologists likely would: be treating combat fatigue, which is similar to exhaustion.

Soldiers who have experienced disruption of sleeping and eating patterns and the threat of death or mutilation will probably experience some form of the condition.

"It's totally normal for a person to get frightened and start to vomit and have diarrhea right at the time of attack. That's a normal reaction to a terrible situation," Price said. "But when a person is doing that all the time, when he can't turn off the alarm reaction and his body becomes so exhausted that he just can't continue anymore, mentally or physically, then we're getting into the battle fatigue area."

Treating battle fatigue includes counseling, but it also entails getting the the servicemember back to his unit as quickly as possible. "If a person can be turned around quickly, then he feels like he's lived up to his obligations and helped his friends in a way that he feels he should," Colosimo said. "Then he doesn't get into a category, or label himself, as a psychiatric case."

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