war trauma

"Me against my brother, my brother and I against our father, our father and us against our tribe, our tribe against the world".  old Khurram saying

Countries ravaged by war for generations perpetuate cultures of fear, paranoia, and personal and tribal vendettas. Marriages are tense and abusive. Children are regimented, punished and abused. Alcoholism or drug addiction are common.

The effects pass down the generations. Military culture is imported into the home. Children of combat veterans experience higher rates of suicide, unemployment, drug and alcohol use, marriage failure, mental illness and lower income and job status than the general population.

Military personnel enjoy the comradeship, the hunt and the kill but there are consequences not mentioned in the glossy recruiting ads. 98% of people after 60 continuous days of exposure to front line combat qualify for a diagnosis of PTSD (Post Traumatic Stress Disorder). The depression, confusion, stress, anxiety, sleeplessness, hyper-vigilance and poor memory can be incapacitating.

The symptoms of PTSD may be covered up for decades by overwork, drugs or drinking until something like the sound of a helicopter or bugle or a supermarket trolley suddenly triggers overwhelming sadness, anxiety, rage or despair which may recur for years after.

guilt
Like other social animals we are hard wired to empathise and experience the emotions of others. We run the scenario of what it feels like to be the other person. The most traumatising experience for almost everyone is to feel responsible for harm to another.

After killing, injuring or targeting someone the conscious mind knows that this is someone else but at some level it is as if it happened to ourself or might happen to ourselves or someone close to us. The world is no longer safe. This is usually unexpected and devastating and resists attempts to ignore it. It recurs in dreams and flashbacks. It is no longer unthinkable to kill someone or for a stranger to suddenly kill you. These may be conscious fears or may just sit below the level of consciousness keeping the body and mind in a state of vigilance.

If a soldier fails to kill their enemy, they fail to do their job, they fail their nation, they fail their training, fail their unit, fail their comrades. If they succeed the world is no longer safe. Damned if you do, damned if you don't.

Peacekeepers may be forced to watch killings helplessly where rules of engagement do not allow interference in local disputes. The long term effects are usually devastating. They may be left with a feeling of powerlessness or responsibility for having not intervened.

Medics and chaplains are exposed to horrific experiences and die at a higher rate than combat personnel but have a much lower incidence of psychiatric casualties because they they are not required to kill at close quarters.

Non combatant officers, technicians and politicians responsible for killing at a distance may experience twinges of remorse but not the depression, anxiety and disintegration of PTSD. Typically they have almost no understanding of the consequences of their decisions on combatants.

demobilising
Basic training is traumatising. Soldiers are trained to respond automatically to orders and to give orders. Identity is reduced as uniformity and conformity are drilled. Soldiers become military assets to be deployed as required. Replaceable and expendable. They expect to obey and be obeyed. On return to civilian life more complex interactions can be difficult or impossible even decades later.

After being trained to kill, soldiers cross the line breaking this taboo. The option has to be consciously resisted after return to civilian life. The reflex to respond violently when threatened has to be suppressed. Drugs or alcohol may strip away this civilised veneer.

Drug or alcohol abuse or over work can mask the effects of PTSD for years or decades until a marriage breaks up, children leave home, physical capacity declines or retirement approaches.

The most difficult phase of PTSD for soldiers is having to revisit incidents when they try to prove war disability for a pension or compensation. This is an adversarial process that is difficult or impossible for someone with a short fuse and little memory. Claims are often frustrated by lost military records and captive government medical opinions. Gathering evidence and rehearsing incidents of past military service is re-traumatising and can be disabling. Many suicide.

The suggestions in johnbrasted.com help wind down and reorganise. Talking through experiences helps come to terms with them. When they have done this veterans are persistent, endure hardship, respond efficiently to crisis and spot dangers invisible to civilians.

copyright (C) John Brasted 2008
updated 06/11/11

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