WASHINGTON (Army News Service, Oct. 24, 2012) -- Emotional pain is real, the Army surgeon general told a group of Soldiers, family members and family readiness group leaders here, Oct. 23.

Lt. Gen. Patricia D. Horoho illustrated the point by showing a montage of news clips and photos of ground zero on 9-11. Horoho spoke during a family forum at the 2012 Association of the United States Army Annual Meeting and Exposition in Washington, D.C.

"What did you just feel?" she asked the audience, after they had viewed the video. "Did you feel anger, sadness, anxiety, or fear? Take a moment to notice how your body reacted. Your palms may be sweating. Your heart may be beating faster. And maybe you're feeling a bit nervous. You just experienced both the physical and psychological response to the memory of a tragic event. Something that happened over 11 years ago immediately evokes emotion as it did back then. Is it real?"

Horoho told the audience that their physical response to the memory was real, and that such a response begins deep in the brain, in the area that controls things like breathing, heartbeat, and blood pressure.

"It is part of the autonomic nervous system," she said. "It's controlled largely below the level of consciousness. This is where your fight or your flight responses come from. Watching that video of 9-11 triggered a chemical and electrical cascade that caused your heart to beat faster, your breathing to quicken and your blood pressure to rise. It also sent information to your frontal lobe to trigger an emotion."

The same thing happens to Soldiers after a firefight or an explosion.

New research, brain imaging and electric impulse mapping, shows that even in a mild traumatic brain injury, sheering forces stretch nerve bundles in the brain. That can lead to both psychological and physical impairments.

"In conflicts past, we didn't understand the links between mental and physical injuries," Horoho said. "Often, the default response was that 'it's all in your head.'"

The general said that such injuries are in a Soldier's head -- deep within their brain.

"The memories, the emotions and the experiences our troops bring home are real," Horoho said. "We understand that now. The psychological responses to the trauma that they've endured are based on real, biological responses from deep within our brains. This is true not only for our Soldiers, but for our families as well."

It can be just as traumatic for family members to watch the 24-hour television and internet news cycle, lose sleep from worry, and panic when they get a phone call that that a loved one has been injured.

"When that call comes, every wife, every husband, every mother, every father and every child remembers exactly where they were," Horoho said. "This is bigger than the Soldier and it isn't an isolated event. The news, and the emotion that news brings, sends shock waves through our units, through our families, our friends and our communities."

Melissa Seigman, founder of the blog "Her War, Her Voice," shared her own struggle with depression during and after her husband's most recent deployment.

"While life went on around me, I stood still, wondering what happened to the woman I used to be," Seigman said. "How could (my husband) be home, safe and sound, and how can my family be so happy and I can hardly get out of bed?"

Seigman said she had to learn how to live again. She said she now hears from many military spouses who are also struggling and encourages them to reach out for help, and to help each other.

Soldiers and families are encouraged to help each other through difficult emotional struggle -- but Horoho said it's her job to make sure that Soldiers have access to that help when they need it.

"It's my responsibility to make psychological health real, to overcome the stigma and to provide evidence-based, prevention, screening, treatment and rehabilitation," the general said.

Army medicine offers behavioral health services in its hospitals clinics now, she said. Additionally, the Army is working to embed behavioral health assets into military units, and continues to focus on resiliency.

Lt. Col. Glenn Schiraldi, now retired, serves as a professor at the University of Maryland School of Public Health. He studied 41 well-adjusted combat survivors from World War II and found they had similar strengths, such as profound love for others, respect for the enemy, a lack of lasting bitterness, self-esteem, morality, dignity and humility.

That kind of resilience can be taught, Schiraldi said.

"Comprehensive resilience training builds skills that are wide enough and deep enough to help people deal with whatever life throws at them," he said. "Once we can strengthen people to deal with a wide range of problems, then we minimize their suffering. We also ease the burden on an already overloaded behavioral health system."

Army wife Jill Crider went through the Army's Master Resiliency Training Course -- reluctantly -- after she found herself overwhelmed after a couple of deployments. She said she was surprised by how much she learned.

"I was going so I could write about it and tell you all why it wasn't the right answer," Crider said. "It wasn't going to be the thing that helped me."

But after participating in the coursework, she tested the techniques and was able to work through her anger. She said she'd have been "much healthier, much more productive and way less crazy," if she had taken the course sooner.

"If you get an opportunity to take the class, take the class," Crider said. "Processing that stress as it happens is what's really important."