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Ex-POWs: Bergdahl Needs, Deserves Time to Adjust

Bowe Bergdahl

WASHINGTON -- The man at the center of a raging controversy over his captivity by the Taliban likely isn't yet aware of the tumult he has precipitated.

Military officials and experts on the prisoner-of-war experience say Sgt. Bowe Bergdahl has been in a protective bubble ever since his May 31 release after five years of Taliban captivity.

Bergdahl, 28, an Idaho native, was exchanged for five senior Taliban prisoners who were transferred from the Guantanamo Bay detention facility to Qatar. He's being evaluated at the military hospital in Landstuhl, Germany.

In part, he's being shielded from anger directed at him, as critics -- including troops who served with him -- charge him with deserting his base and endangering his comrades in arms, a number of whom were killed or injured in subsequent searches.

Poll: What Do You Think of Bergdahl's Release? 

But he's also being shielded from the damaging disorientation that can occur when long-held captives return to society without proper reorientation.

"When you have prolonged captivity -- five years -- someone is going to be a little bit like Rip Van Winkle," said Dr. Frank Ochberg, a pioneering psychiatrist in the field of trauma recovery who helped develop key concepts, including that of post-traumatic stress. "It's a slice of your life that has been taken out."

But lost time may pale in significance to other damaging effects of being a prisoner of war, Ochberg said. Although it's not yet known what Berghdahl might have experienced, other survivors of long-term captivity have suffered ill effects of prolonged isolation, mistreatment and horrifying experiences, leading to the onset of painful and potentially crippling post-traumatic stress injury, he said.

So what's happening to Bergdahl now?

Although the military has declined to release specifics about his physical and emotional state, officials have detailed the U.S. military's three-phase POW "reintegration" program, which Bergdahl entered as soon as special forces troops took him from his Taliban captors in a pre-arranged handoff.

The program's roots lie in the 1973 return of hundreds of POWs in "Operation Homecoming" and has been fine-tuned using medical and psychological research done in the intervening decades.

"Reintegration has been going on for years," said Arwen Consaul, a spokeswoman for U.S. Army South, which treats returned Army POWs as well as other troops and civilians held in U.S. Southern Command. "Since the Vietnam POWs came back, we realized there needed to be a process to get them back into society and be able to cope with what they'd been through. Through years of studying POWs and talking to POWs, we've been able to continually refine our process."

Phase 1 of reintegration begins as soon as a POW is released and involves initial medical treatment and psychological support in the theater where the release occurs. Each phase of the process involves debriefing of the returned POW, focusing especially on any tactical information the returnee may be able to immediately provide to the military.

Bergdahl is currently in Phase 2 of the process, known as "decompression," which experts say can last from three days to a few weeks. For Bergdahl, this phase is taking place at Landstuhl. Although stable, he requires nutritional care after years of bad food, as well as other medical work military officials have refused to elucidate.

Vietnam POWs released during Operation Homecoming underwent a three-day period at Clark Air Base in the Philippines that bears some similarity to the current decompression regimen. It was a welcome step that eased the way back to life in the United States, one former POW said.

"It would not be a wise thing to do, I think, to take a guy and throw him back in with his family before the military has had a chance to talk with him or debrief him," said retired Navy Capt. Mike McGrath, a pilot who spent almost six years in a North Vietnamese prison and was tortured after being shot down in 1967.

But it's not just talking that Bergdahl is likely undergoing, McGrath said. After five years of arduous captivity, he may have medical needs similar to those of the Vietnam POWs.

"We had a lot of guys missing teeth, from beatings or rocks in the food or whatever," he said. "When we got to Clark, they had a whole bank of dentists ready. They were taking care of periodontal disease, and if you had broken out teeth they were making temporary bridges so you could meet your family with no teeth missing. That might seem pretty small to you, but to guys meeting their families for the first time in years, it meant a lot."

Other prisoners were suffering from parasites, long-term infections and open wounds that needed treatment, McGrath said.

During decompression, according to an Army fact sheet, former POWs are attended to by team that includes medical personnel and at least one psychologist trained in survival, escape, evasion and resistance. The phase also includes operational and intelligence briefings.

Pentagon officials have declined to offer details on the specific nature of Bergdahl's debriefings. But if the sergeant engaged in misconduct in connection with his disappearance from his base in Paktika province in 2009, he may be subject to discipline, Chairman of the Joint Chiefs of Staff Gen. Martin Dempsey said Tuesday on his Facebook page. "Our Army's leaders will not look away from misconduct if it occurred," he said.

But, echoing other Pentagon statements, Dempsey added that simply caring for Bergdahl and his family after a horrific ordeal is the priority now.

Ochberg, who has spent a career treating and interviewing military and civilian survivors of trauma, said he trusts Dempsey and other leaders that Bergdahl is being treated as a patient rather than a suspect. Although the term "debriefing" may sound intimidating, it can be a key part of the healing process, he said.

The first step is to not be too intrusive, he said.

"When I am a psychiatrist talking to someone who has been through quite an ordeal, rather than just talking about what's going on with them, it's important to establish a good relationship -- to have a conversation rather than an interrogation, and be cautious in exploring traumatic and painful events," he said.

In the right hands, debriefing is positive, he said. Research on victims of conflict who'd been given a chance to tell their story to sympathetic listeners in tribunals overseas shows they had better psychological outcomes than those who did not speak about it, Ochberg said.

Now is not the time to try to build a disciplinary or legal case against Bergdahl, he said.

"I assume that what is going on now is medical and is what the secretary of defense has said and the president has said it is," he said. "If it turns out that the investigation shows that anybody tried to take advantage of a weakened state, I would consider that a miscarriage of justice."

In Phase 3 of reintegration, which will occur at San Antonio Military Medical Center, Bergdahl will be reunited with family and begin to move back slowly into normal life in America.

"Families play a critical role in assisting the returnee in gaining control and predictability over their circumstances," according to an Army fact sheet. "The key is to include the family in the reintegration planning to ensure they understand the benefits of the process."

During this final phase, which officials said can last weeks or longer, Bergdahl will be attended to by a large, multidisciplinary team that has been monitoring his case and planning for his return for years in twice-yearly meetings, said Consaul of Army South.

Among them are planners, air crew, chaplains, medical personnel, public affairs officials and attorneys, she said.

"We want this to be as seamless for the family as possible so they can focus on the reintegration process," she said.

The Bergdahl family, Ochberg said, has appeared as a model of love and support throughout their son's long captivity. So has his hometown of Hailey, Idaho, he said.

A warm homecoming can make a difference, Ochberg said. But so can a harsh one, which Bergdahl may soon experience as questions about why he became a POW in the first place heat up. At some point in his three-phase reintegration, he'll have to be exposed to what many of his former comrades are saying about him now.

"We know from bitter experience that a poor reception after military service reduces the psychological health of the veteran, and that a warm reception helps," he said.

Regarding Bergdahl: "There's a lot of assumption and presumption, and it's unfortunate from a medical point of view when an individual becomes the focus of a raging controversy," Ochberg said.

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