New book: UH Hilo Professor of Psychology Chris Frueh investigates medical-psych injuries in former military special operators
In his research, clinical psychologist Frueh has uncovered a pattern of interrelated afflictions: traumatic brain injury, hormonal dysregulation, sleep apnea, chronic pain, depression, anger, insomnia, addiction, existential angst, and more — Operator Syndrome.
By Susan Enright.
A new book by Chris Frueh, a professor of psychology at the University of Hawaiʻi at Hilo, identifies and describes the profound impact that years of extreme sacrifice have had on military special operators and their loved ones.
To be published March 26, 2024, the book Operator Syndrome is the result of Frueh’s 30 years of experience in clinical trials, historical epidemiology, and neuroscience research, including over a decade investigating the physical and mental health of special operators across all branches of the U.S. military — Green Berets, Navy SEALs, Air Force PJs, Marine Raiders, and others. Frueh’s discoveries are stark: military personnel are plagued with a unique and brutal combination of injuries born out of years, even decades, of fighting the Global War on Terror.
“[My] work on Operator Syndrome is changing the way we understand and treat the complex set of interrelated health, psychological, and interpersonal difficulties that are common downstream outcomes of a career in military special operations,” says Frueh.
Operator Syndrome
In his research, clinical psychologist Frueh has uncovered a pattern of interrelated afflictions: traumatic brain injury, hormonal dysregulation, sleep apnea, chronic pain, depression, anger, insomnia, addiction, existential angst, and more; his new book guides the reader through the harrowing terrain of Operator Syndrome. He provides a roadmap to understand its multifaceted origins and complex effects on every biological system in the body — as well as the social systems of family, work, and the indifferent society to which the warrior returns.
“I see lightbulb moments in the room which is usually followed by an intense sigh of relief,” says Frueh about veterans hearing his findings. “So many of them have been told over and over again that there is nothing wrong with them — that their MRI was normal or their t-levels were normal (according to the branch’s standards) and that it must be PTSD or some other mental health ‘issue.'”
Frueh says for decades the field of mental healthcare has not paid much attention to the role of hormones, chronic pain, brain injuries, and even quality sleep as they relate to what is often labeled and treat as psychiatric disorders.
“For too long, the VA and DOD have relied on the ‘easy button’ of a PTSD diagnosis,” says Frueh. “In my work with military special operations, it seems that Navy SEALs, Army Green Beret’s, Marine Raiders, Air Force Pararescuemen, etc., typically do not have PTSD; but instead have a far more complex set of interrelated health, psychological, and interpersonal difficulties that are common downstream outcomes of their careers.”
This includes traumatic brain injuries from both impact forces and blast exposures, which cause different types of injury. They also typically have low testosterone and other hormonal dysregulation, obstructive sleep apnea, and debilitating chronic joint pain.
“The DOD and VA have largely failed a generation of elite warriors by putting the focus primarily on mental health diagnoses and treatments,” says Frueh. “I’m working with others to bring about a paradigm shift in how we care for elite warriors — which also has important implications for other Veterans and First Responders.”
Frueh is further facilitating this shift with his new book through providing real solutions, lifestyle adaptations, and step-by-step treatment strategies that have worked for hundreds of operators, saving lives and giving hope to families.
Including his students in the research
Frueh has included his students in many aspects of his research. A group of UH Hilo psychology majors and an alum participated over the summer of 2021 in an internship program at the SEAL Future Foundation; four went on to volunteer at the Military Special Operations Family Collaborative.
- Read more about this summer project: UH Hilo psych students and alumna intern with military special operations health foundations (UH Hilo Stories, Sept. 30, 2022)
Frueh’s work is studied by students in the courses he teaches at the university, focusing on changes in the field and understanding the ways in which mental health is treated, especially among veterans. When the SEAL Future Foundation reached out to Frueh in search of guidance in expanding their program, the psychology professor found it to be a great opportunity for his students to be part of the process. The nonprofit group was happy and open to allowing student interns to support their efforts while gaining experience in the field.
Students also did volunteer work with another group called Military Special Operations Family Collaborative, a nonprofit public health initiative in support of the special operations community.
“The contributions made by our team of students and alumni, including their fresh perspectives, was greatly appreciated by the leadership at both foundations and also by me” says Frueh. “It also seemed to be a valuable real-life learning experience for them.”
Firefighter Syndrome
Frueh’s work also covers the health of first responders, notably firefighters with what the professor and his team of researchers have identified as Firefighter Syndrome.
This research is recently cited in a publication of the U.S. Department of Homeland Security on “Firefighter Psychological Health.”
The DHS publication notes that Frueh’s research team identified that the amount of research on firefighter health and wellness is significantly smaller when compared with military veterans. The research team concludes that addressing Firefighter Syndrome requires a whole systems approach to understand the culture and treatment needs of career firefighters.
National recognition
Frueh’s work has gained national attention.
He has testified before U.S. Congress and served as a paid consultant for the Department of Defense, Veterans Affairs, the U.S. State Department, and the National Board of Medical Examiners. He has also published commentaries in National Review, Huffington Post, The New York Times, Time, Men’s Journal, and Special Operations Association of America. He has been quoted or cited in The Wall Street Journal, The Economist, The Washington Post, Scientific American, Stars and Stripes, USA Today, Men’s Health, Los Angeles Times, Reuters, Associated Press, and NBC News, among others.
Frueh is currently being featured in a number of podcasts and video interviews about his new book.
Frueh devotes much of his time to SEAL Future Foundation, HunterSeven Foundation, Special Operations Association of America, Boulder Crest Foundation, Military Special Operations Family Collaborative, The Mission Within, VETS, Inc., and Big Country Veterans. He has also published nine historical crime novels, including They Die Alone (2013) and, most recently, A Season Past (2019).
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Story by Susan Enright, a public information specialist for the Office of the Chancellor and editor of UH Hilo Stories. She received her bachelor of arts in English and certificate in women’s studies from UH Hilo.
