Maj. Gen. David Blackledge, right, is among the first of senior leaders to publicly talk about his post-combat issues in an effort to encourage other soldiers to do likewise. Blackledge suffered serious back injuries on one Iraq deployment when his vehicle flipped several times after the driver tried to evade an ambush. He was also injured in the 2005 suicide bombings of three Amman, Jordan hotels. As a result, he experienced not only chronic physical pain but psychological issues as well: frequent mental replays of the ambush, mood swings, nightmares that left him drenched in sweat. "We're not as invulnerable as we think we are," he said. (Photo courtesy of David Blackledge)

Maj. Gen. David Blackledge, right, is among the first of senior leaders to publicly talk about his post-combat issues in an effort to encourage other soldiers to do likewise. Blackledge suffered serious back injuries on one Iraq deployment when his vehicle flipped several times after the driver tried to evade an ambush. He was also injured in the 2005 suicide bombings of three Amman, Jordan hotels. As a result, he experienced not only chronic physical pain but psychological issues as well: frequent mental replays of the ambush, mood swings, nightmares that left him drenched in sweat. "We're not as invulnerable as we think we are," he said. (Photo courtesy of David Blackledge)

Brig. Gen. Loree Sutton, chief of the newly created Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. (Photo courtesy of DOD)

A real warrior will always place the mission first, never accept defeat, never quit and never leave a fallen comrade, according to the U.S. Army Warrior Ethos.

But what if he does all that, then has problems when he gets back home? What if he has post-traumatic stress disorder or nightmares or feels distant from his family?

Who are the real warriors then?

Army psychiatrist Brig. Gen. Loree Sutton is hoping to persuade soldiers that the real warriors are the ones that reach out for help with post-combat psychological issues.

“Reaching out and connecting — it’s a sign of strength,” said Sutton, head of the Defense Department’s Centers of Excellence for Psychological Health and Traumatic Brain Injury.

This spring, the center intends to unveil a $2.7 million campaign designed to help remove the still pervasive stigma from seeking mental health services — and persuade soldiers that the era of the strong, silent type is over.

Called “Real Warriors, Real Battles, Real Strength,” the campaign is modeled on one the National Institute of Mental Health did some years ago to persuade more men to seek treatment for depression. That one was called “Real Men. Real Depression” and featured manly men who had sought treatment discussing how they had been helped.

Likewise, the Real Warriors campaign is to feature stories from soldiers who had post-combat issues and sought help openly — not treating it as some shameful secret. The real secret, Sutton said, is how common — and normal — post-combat psychological issues are.

“We’re not all as invulnerable as we like to think we are,” said Army Maj. Gen. David Blackledge, one in the vanguard of senior officers and enlisted who’ve already signed up to discuss their stories. “Clearly talking to someone who’s trained and can help you understand what and why (your symptoms) are happening is very helpful. But the realization that there’s nothing wrong with you — that this is a normal response — makes it OK.”

Blackledge had severe symptoms following his Iraq deployments. He was at one of the Amman, Jordan, hotels hit by suicide bombers in 2005.

Worse, though, was what happened in 2004, during an ambush in Iraq.

Blackledge’s Humvee flipped over several times, crushing his vertebrae and breaking his ribs. His interpreter was shot through the head.

Blackledge crawled out, and he and others survived a firefight by taking cover in a ditch.

When he got home, he had nightmares from which he awoke drenched in sweat, and he constantly replayed the ambush over in his mind, he said. “I’d be totally happy one minute, and then something would happen and I’d want to kill somebody,” he said.

Blackledge sought treatment for his physical and psychological pain, and doesn’t see much difference between the two. “If you broke your leg, no one would question it,” he said. “Your brain is just another part of your body that can get injured.”

Now, he still dreams about the ambush but not so often, and the dreams are less terrifying. “It’s almost hard to call them nightmares anymore,” he said.

The Real Warriors campaign is part of a larger effort to address troops’ psychological health in the face of what have been lengthy and repeated deployments, increasing risks for traumatic brain injuries and post-combat stress. But seeking psychological treatment is still often seen by troops as both a sign of weakness and a bad career move in a culture that traditionally values stoicism, and strength is seen as invulnerability.

According to a military mental health task force report in 2007, the stigma “remains a critical barrier to accessing needed psychological care.”

Sutton says she sees the campaign lasting at least three years. That would mean changing the culture, she said, so that seeking mental health services is no longer discouraged, as it still sometimes is, by what she called “toxic leadership.”

“As we transform the culture … the toxic leadership will stand out as being what it is,” she said.

So far, Sutton said, she had recruited eight soldiers willing to participate, a staff sergeant, a first sergeant and a major among them, all willing to discuss their own experiences. “I am not alone. That’s a fundamental lesson that leads the campaign,” she said.

Blackledge said he would like to see some sergeants major come forward. “I think that would be huge,” he said.

Not everyone needs to be interviewed by the press, he said. The value is really in soldiers and their spouses talking to their peers.

“I’ve got two siblings; as much as they care about me, they just don’t have the same frame of reference,” Blackledge said.

But the people in the ambush with him? They know. He was recently in contact with two of them. “One of them still has dreams about it as often as I do,” Blackledge said.