Normal reactions to an abnormal event

In her own observations, Marrs noted that Green had abnormal eye contact, including staring, and that his mood was angry. Green told Marrs he was having suicidal and homicidal ideations, especially thoughts about killing Iraqi civilians. On his one-page intake sheet, Marrs noted his wanting to kill Iraqis four separate times. One entry states, “Interests: None other than killing Iraqis.”

She diagnosed him with Combat and Operational Stress Reaction (COSR), an Army term to describe typical and transient reactions to the stresses of warfare. COSR is not a condition recognized by the Diagnostic and Statistical Manual of Mental Disorders-IV, the bible of the psychiatry profession, something the Army is well aware of, since it doesn’t even consider COSR an ailment. As one Army journal article puts it, “Those with COSR are not referred to as ‘patients,’ but are described as having ‘normal reactions to an abnormal event.’ ” Thus believing Green’s psychological state to be normal, Marrs prescribed him a small course of Seroquel, an antipsychotic drug that also treats insomnia, and recommended that he follow up with another visit (though she didn’t specify when), and she sent him back to his unit.

—Jim Frederick, Black Hearts, (New York: Harmony Books, 2010), 157-58.

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