War in the Age of Technology: Myriad Faces of Modern Armed Conflict

11. Post-Traumatic Stress Disorder: The Legacy of War

chapter 11 ✦ ✦ ✦ ✦ ✦ ✦ ✦ ✦ ✦ ✦ ✦ Post-Traumatic Stress Disorder The Legacy of War Andrew Wiest, Leslie P. Root, and Raymond M. Scurfield Our choices are to be hurtled blindly into the next abyss because we refuse to recognize the living legacy of war, the survivors, or instead to come to terms with the world we have created by understanding the human costs of Vietnam. . . . In the aftermath of any war, it behooves us to recognize the profound price paid by the soldier survivors.1 The first portion of this chapter, written by Andrew Wiest, investigates battlefield trauma from a historical perspective.2 One of the great philosophical arguments throughout the ages centers on the most basic of human questions: Is mankind inherently good or bad? Are we little more than savages that the world would be better off without, or are we a perfectible species, born of a divine love? If mankind is, in fact, good, then it is quite possible that combat should be considered an inhuman aberration. Indeed, much of history can be seen as an effort to curb the killing instinct of mankind. The rule of law, the beauty of philosophy, and the wonder of religion all point the way to peace. Hammurabi, Lao-Tze, Jesus, and Mohammed, among many others, begged their followers to follow a peaceful path in life. Even so, humanity continues to be violent and often kills in the name of law, philosophy, or religion. Yet for modern mankind, with the exception of a few sociopaths, killing and combat are remarkably 295 difficult.3 The societal taboo against killing, though not always effective , is powerful. Thus, when one takes part in combat, one must shed the thin veneer of society and take part in the act of killing that is so repugnant to the human experience of nearly four thousand years of history . The result of such action can be devastating and quite traumatic. The story of trauma and war dates back into the distant past. The earliest Western work on warfare, Homer’s Iliad, is based on a story of betrayal, death, and revenge that is uncomfortably familiar to many modern veterans. The combat is often one on one and very close range, but the result is the same. Even the mighty Achilles is quite shaken by his role in the carnage. In fact, the Iliad can be read as an account of the undoing of the character of Achilles by the ravages of war.4 Over millennia, the effects of industry and technology have changed the battlefield quite dramatically, but only superficially . Modern, technological war is more extensive and lethal than the ancients could have imagined. Thousands can die in an instant at the hands the frightening array of modern weaponry. Yet, death, maiming, and terror remain at the center of the modern conflict. Modern warriors may meet their enemy only rarely in hand-tohand combat, as Achilles met Hector, but the rather detached nature of modern battle does not insulate today’s soldier from death and killing. Soldiers in present and future wars will still have to face the threat of being killed, the horror of watching a friend die, and the possibility of killing another human being. A Vietnam veteran remembers a kill: And I froze, ’cos it was a boy, I would say between the ages of twelve and fourteen. When he turned at me and looked, all of a sudden he turned his whole body and pointed his automatic weapon at me, I just opened up, fired the whole twenty rounds right at the kid, and he just laid there. I dropped my weapon and cried.5 In the end, technology has increased the lethality and the trauma associated with battle. This conversion in the nature of war happened quickly at the beginning of the twentieth century. The new, technological battlefield was so traumatic that every army in the wiest, root, and scurfield 296 Western world took note of a disturbing new trend, a dramatic rise in the level of psychiatric casualties in battle. Science had changed the battlefield, but combat itself was now so intense that many soldiers broke under the strain. Since the diagnosis of “shell shock” in World War I, psychiatrists and psychologists have grappled with the effects of modern battle on the human psyche. It was and is a vitally important yet formidable struggle. Military powers throughout the world are understandably more...