More than 100 soldiers in a Philadelphia hotel room are undergoing a different type of military training - Comprehensive Soldier Fitness, or CSF. Workshops like this represent the Army's response to hidden emotional wounds from repeated combat deployments that are thought to lie behind alarming levels of suicide in the military.
"You're starting to see some fissures and some holes in our force, and you see it manifested in [post-traumatic stress disorder and] increased suicide rates," said Col. Darryl A. Williams, deputy director of the CSF training program.
"This is a recognition by Army leadership that we need something that will endure, that's long-standing and will increase the fitness of our force so that we don't unravel," Col. Williams said.
That recognition has been particularly visible this year, with the Army creating a Suicide Prevention Task Force.
The recent mass killings at Fort Hood, Texas, purportedly by a troubled psychiatrist, have added a greater sense of urgency for the military to deal proactively with the mental health of its troops.
At a briefing this month, Army Vice Chief of Staff Gen. Peter W. Chiarelli said 2009 likely will end with more suicides than last year. By the end of October, the number of suicides in the Army equaled 140, the total for all of 2008.
"I am trying to change what I believe is a culture in the Army to look at these invisible wounds as something less than a broken bone or the loss of an arm or a leg," Gen. Chiarelli said.
CSF training moves away from an approach that triages people to problem-specific counselors after a problem has been identified toward an approach that gives soldiers and their families skills to cope ahead of time.
"I think this will decrease the number of folks that will end up in the mental health clinics," said Master Sgt. Richard Gonzales, who has administered mental health services for 21 years in the Army.
"We've been good about raising awareness, but now we're giving [soldiers] the skills to do something about [their problems.]"
CSF was designed by University of Pennsylvania psychologists to help soldiers build mental toughness, strengthen relationships and improve communication in order to face adversity more effectively.
It extends to mental fitness the same approach that the Army takes toward physical fitness, including assessment, training and reassessment.
Unfortunately, the effort comes too late for Spc. Timothy Bowman, who took his life on Thanksgiving Day four years ago.
Eight months earlier, the Illinois National Guardsman returned from a 12-month tour in Iraq, said his father, Mike Bowman.
"When he came home, he was distant. His anger levels were elevated. Trigger points would set him off," Mr. Bowman said in an interview. "He had all the classic signs of [post-traumatic stress disorder], and we didn't know because we didn't know what we were looking for."
Facing yet another painful holiday, Mr. Bowman said he can't help but question whether the Army is doing enough to prevent suicides.
"You can't really tell what's going to work because everyone is different," he said, adding that mandatory training for everyone is key in military culture. "That way no one is singled out."
It's important that everyone, including reservists and National Guardsmen, get trained as well, Mr. Bowman said.
Retired Air Force Capt. Ed Colley, whose son, Pfc. Stephen Colley, took his life in 2007, has similar doubts.
While soldiers who are motivated to show good leadership will recognize the value of the suicide prevention program, he said, it is unlikely to impact those who are not good leaders.
"Part of the Army's suicide problem - I believe - is poor leadership, and my fear is that this training won't impact that problem," Capt. Colley said in a separate interview.
He said his son, like many others, had been heavily affected by a recent deployment and a failed marriage.
Maj. Damon Delarosa recalled that after his 2007 deployment to Iraq, 45 of his 250-soldier company got divorces, including him.
"There wasn't a good mechanism in place to help soldiers. The chaplain was a busy man. It was either that or the combat stress [guy]," he said.
"I wasn't impressed with what they were able to do. It was mostly medication or taking them out of the mix. There has to be a way to continue to accomplish missions [and get help.]"
The 125 soldiers and military family members in this month's CSF training are learning how to train others. The Army has mandated an online resilience assessment for all soldiers, with incentives to complete the training through promotion points and college credits.
"It's a long time coming, and it needed to come a lot sooner," said Sgt. First Class Carlos Santillana, who attended the two-week training in Philadelphia.
Sgt. Santillana has completed two combat tours in Iraq. He said he saw a variety of psychologists after his first deployment but found they couldn't truly understand his perspective. One strength of the CSF approach, he said, is that it doesn't rely on mental health professionals, but on soldiers helping soldiers.
"[CSF] can exponentially increase the number of psychological survivors from the wars," he said. "The guys that come back and don't have these tools or someone to sit down with - you need to learn about this and try these things and implement them in your life, and since we're going to be in their units, they can come back to us when they have a question."
Several trainees remarked on the difficulty of the transition between battle and family life for those repeatedly deployed.
"You spin up, you deploy, you reintegrate," said Maj. Gerald New. With this training, "the integration is always ongoing - there's never a clean break between deployment and reintegration [with your family] because you never stop having the conversations with family," he said.
The Army is focused on training officers so they can train new recruits. Col. Williams said he is designing a parallel program for Army families that can be administered through family readiness groups.
Command Sgt. Maj. Teresa King, the first female commandant of the Army's Drill Sergeant School, is already implementing CSF with her soldiers and said she finds it helpful.
"I've used it with my family - for me. I'm not as stressed as I was," she said.
"To those soldiers who I'm on the phone with who've lost their wives, lost their girlfriends, who are depressed, that their buddies don't know about, to the soldiers who are pulling the trigger, to the soldiers who are hanging themselves using a chord - what do you say to them?" Sgt. King asked.
"I think I'd have something to say now. I have more to say."