When it comes to post-traumatic stress disorder (ptsd) and its impact on members of the Canadian Armed Forces (caf), the predominant message in the mainstream media is negative. The message found in many of the headlines is clear: those who suffer from trauma and their families are irreversibly injured with little hope for recovery. Lieutenant General Roméo Dallaire’s recent memoir Waiting for First Light (Random House Canada, 2016) offers an example of the bitter struggle trauma can cause. In The Invisible Injured, historian Adam Montgomery considers psychological trauma over a century, beginning [End Page 331] with the transformative period of the Great War when technology heightened the destructive nature of war, causing many soldiers to suffer from what was then called “shell shock.” He then traces mental trauma through the next 100 years. His long view enables the reader to consider the continuity and change of trauma and its relation to military culture.
The first half of the book pulls together existing secondary literature, tracing the historical interpretations of the current designations from shell shock, to battle exhaustion, to ptsd, including a discussion of the contemporary psychological and medical professions, to consider how mental trauma fits within the respective social and scientific contexts. The second half of the book, save for an important contextual chapter on the Vietnam conflict, focuses on Canada’s conflicts after the Second World War, ending with the conflict in Afghanistan. There are two themes that emerge from Montgomery’s century-long view. The first is the importance of language and the social context of trauma. The enduring struggle to find an appropriate designation reflects the unique social conditions that contribute to, and shape, how trauma injuries are perceived. The difficulty in naming trauma injuries demonstrates the problematic nature of the “invisible” injury. The current designation of “ptsd” was only coined in 1980, largely because of the persistence of doctors fighting for the acknowledgement of the psychiatric problems of Vietnam veterans (96). It remains questionable whether the term ptsd, with its roots in the Vietnam conflict, accurately reflects the many effects of trauma injuries. It also does not demonstrate why trauma injuries affect some but not all.
The second major theme in Montgomery’s book highlights a paradox. The necessary perpetuation of a masculine military culture means that the stigma around trauma-related injuries remains strong. This stigma has roots in how trauma-related injuries were perceived and discouraged in the Great War. “Shell shock” and its treatment was a product of medical understandings, gender roles, the massive changes of the century, and the destructive nature of the war. But, as Montgomery shows, social contexts and conflicts have changed significantly. Yet the testimonies he uses indicate that the stigma remains, although the social context, the medical profession, and the nature of conflict have changed. The lack of testimony from female soldiers leaves this reader with some questions: are women less likely to suffer trauma; are they just not part of the sample set; what can their story tell us about trauma and military culture?
The major contribution of The Invisible Injured emerges in the second half of the book with the first-hand testimonies that reveal that [End Page 332] trauma injuries remain a major problem in the caf, despite progress in the fields of psychology and medicine. Combat operations in Afghanistan ended in 2011, and it will be decades before historians have access to the sources that will enable them to look objectively at the conflict. Still, Montgomery’s focus on the services and programs offered by the caf, paired with the personal testimonies of the soldiers involved, shows the legacy of a masculinized military culture that perpetuates stigma, despite the efforts of the caf to improve programs, services, and training to better accommodate its soldiers and veterans.
As Montgomery points out, despite the century of experience with trauma-related injuries, the problem remains significant as soldiers continue to die by suicide. Although the statistics...