Lid romerske tropper af PTSD?

Lid romerske tropper af PTSD?


We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

Efter krigene i Afghanistan og Irak har der været talt meget om, hvor mange soldater der lider af PTSD, når de vender hjem.

Jeg er interesseret i at vide mere om krigstraumer og PTSD i gammel krigsførelse. Det ville måske være nyttigt at indsnævre det til ladene sige romertiden.

Jeg forestiller mig, at krige dengang kan betragtes som mere "brutale" end det, vi har i dag, de fleste kampe sker i meget tæt kamp med mange døde og sønderdelte lig liggende (i modsætning til de relativt små engagementer, moderne hære er vant til i dag og selvfølgelig har kamppartierne en tendens til at holde større afstande imellem sig i dag). Mit første gæt ville være, at soldater, der overlevede disse forlovelser, ville lide af frygtelige traumer.

På den anden side ville disse mennesker have ført mere "brutale" liv, end vi har i dag. Jeg forestiller mig, at de ville have været udsat for vold i yngre aldre (korsfæstelse af kriminelle, argumenter, der ender med sværd, dyr og muligvis menneskelige ofre, flere tilfælde af død omkring dem osv ...). Derudover forestiller jeg mig, at deres kultur og religioner sandsynligvis har forberedt dem på dette niveau af vold. Sammenlign det med barndommen og det liv, den gennemsnitlige (kristne, religion, der ikke rigtigt forbereder sig på krig og vold), vesterlænder, før han ser krig for første gang.

Jeg er især interesseret i at vide, om nogen gamle forfattere efterlod nogen optegnelser, der talte om krigstraumer hos soldater i deres tid?


PTSD, eller stressreaktioner fra kamp, ​​var velkendte under den græske og romerske æra. Grækerne forstod det meget godt. Alexander den Stores mænd siges at have mytteret efter at have lidt "kamptræthed".

Disse eksempler på romertiden PTSD er hentet fra en blog med gamle eksempler hentet fra Max Hastings ', An Oxford Book of Military Anekdotes:

Ifølge Herodot, i 480 f.Kr., i slaget ved Thermopylae, hvor kong Leonidas og 300 spartanere tog imod Xerxes I og 100.000-150.000 persiske tropper, rapporterede to af de spartanske soldater, Aristodemos og en anden ved navn Eurytos, at de led af en "Akut betændelse i øjnene", ... Mærket tresantes, der betyder "rysten", ...

Under den romerske belejring af Syracusa i 211 f.Kr. var en række græske soldater, der forsvarede byen, "ramt stumme af terror" ifølge den græske historiker Plutarch. Surdomutisme, som nu anerkendes som en almindelig konverteringsreaktion på kampens stress, blev første gang diagnosticeret klinisk under den russisk-japanske krig i 1905.

Ifølge Peter Connolly skrev den græske militærhistoriker Polybius, at den romerske hær allerede i 168 f.Kr. var ganske fortrolig med soldater, der bevidst skadede sig selv for at undgå kamp.

Ifølge The VVA Veteran, en kongresorganisation:

Aristodemos (eksempel ovenfor) hang senere i skam.

Den fortæller historien om en anden spartansk kommandør, der blev tvunget til at afskedige flere af sine tropper i slaget ved Thermopylae -passet i 480 f.Kr.

"De havde intet hjerte til kampen og var ikke villige til at tage deres del af faren."

Også:

Den græske historiker Herodotus citerer skriftligt om slaget ved Marathon i 490 f.Kr. en athensk kriger, der blev permanent blind, da soldaten, der stod ved siden af ​​ham, blev dræbt, selvom den blindede soldat "blev såret i ingen dele af hans krop." Således er også blindhed, døvhed og lammelse blandt andre forhold almindelige former for "konverteringsreaktioner", der opleves og veldokumenteres blandt soldater i dag


Under romernes kampe med Hannibal fra Kartago var slaget ved Cannae det værste. 50 tusinde romere blev omkranset og dræbt i løbet af få timer, da støvet lagde sig og soldater kunne brænde de døde, fandt de romerske soldater i midten, der bogstaveligt talt var faldet og forsøgte at kvæle sig selv og undslippe blodbadet ved at bure hovedet i jorden. Tilsyneladende har krig altid bragt mænd til skrækindjagende og mørke steder. Jeg kan ikke forestille mig at se det niveau af blodbad udfolde sig foran dig og være fjernt notmal igen.


Hvad siger Bibelen om PTSD?

Bibelen siger ikke noget specifikt om posttraumatisk stresslidelse eller PTSD. Men vi kan hente megen vejledning fra nogle indirekte lærdomme i Bibelen.

Posttraumatisk stresslidelse udvikler sig hos nogle mennesker efter en traumatisk hændelse. Begivenheden eller "stressfaktoren" kan være udsættelse for død eller truet død, faktisk eller truet alvorlig skade eller faktisk eller truet seksuel vold. Den syge kan blive direkte udsat, indirekte udsat for et familiemedlem eller en nær ven, der oplever begivenheden, eller ekstremt eller gentagne gange indirekte udsat for sit arbejde (f.eks. Førstehjælpere, politifolk, militærpersonale eller socialrådgivere). Almindelige traumeoplevelser er kamp, ​​bilulykker, naturkatastrofer, overgreb, voldtægt og massevold. (Det skal bemærkes, at bekæmpelse af PTSD er en smule anderledes end andre former for PTSD, dette vil blive diskuteret mere detaljeret nedenfor.) Efter en sådan begivenhed vil de fleste mennesker vise tegn på stress som at føle sig på kanten, angst, frygt, vrede , depression, følelse af løsrivelse, ønske om at undgå traumerelaterede påmindelser, tilbageblik, søvnbesvær, hovedpine, ændringer i appetit, irritabilitet, selvbebrejdelse, "overlevendes skyld" eller følelse af følelsesløshed. For de fleste mennesker falder disse reaktioner og falder til sidst med tiden.

Dem, der udvikler PTSD, har vedvarende symptomer i mere end en måned. Andre symptomer for PTSD-lider omfatter indgribende genoplevelse af traumer såsom gennem tilbagevendende, ufrivillige minder, mareridt eller dissocieringsundgåelse af traumerelaterede tanker eller følelser eller eksterne påmindelser negative ændringer i tanker eller adfærd, herunder manglende evne til at huske detaljer relateret til traumer, vedvarende negative overbevisninger om sig selv eller verden, tab af interesse, følelse af fremmedgørelse eller manglende evne til at udtrykke positive følelser og ændringer i ophidselse eller reaktivitet såsom irritabilitet, aggression, hypervigilance, hensynsløs adfærd eller søvnforstyrrelser. Hos PTSD -patienter forårsager disse symptomer betydelig nedsat arbejds- eller social funktionsevne. USA's National Center for PTSD anslår, at der er 5,2 millioner voksne, der lider af lidelsen i et givet år.

De situationer, der forårsager posttraumatisk stresslidelse, er forskellige for forskellige mennesker, og ikke alle reagerer på lignende måder på lignende situationer. Det er uklart, hvorfor nogle udvikler PTSD og andre ikke. Det ser ud til, at biologisk make-up, type støtte modtaget efter begivenheden, tilstedeværelse af andre livsstressorer og at have effektive mestringsmekanismer kan bidrage til, om en person udvikler PTSD. Interessant nok, selvom symptomer på PTSD normalt opstår umiddelbart efter eller inden for et par måneder efter den traumatiske hændelse, er det ikke altid tilfældet. PTSD kan udvikle sig år senere. Hvor længe PTSD varer, varierer også, og mdashsome lider i årevis, mens andre genopretter om flere måneder.

PTSD som følge af deltagelse i kamp synes at være unik fra andre former for PTSD. I kampsituationer er militært personale ofte både offer og aggressor, en dynamik, der tilføjer kompleksitet til problemet. Ofte vil personer med kampspecifik PTSD udvise depression, ekstreme skyldfølelser, overvågenhed og lavt selvværd. Det kan være særligt svært for kampveteraner at behandle gennem de grusomheder, de har været vidne til, komme til et sted for accept over de ting, de har fået til opgave at omstille sig til ikke-kampliv. For kristen militærpersonel kan det være særligt svært at acceptere at tage livet af en anden, selv som en krigshandling. Kristne kender den dybe værdi, Gud tillægger menneskeliv og føler sig ofte ekstremt skyldige i at have taget en andens liv, selv under hvad der ville blive betragtet som en berettiget omstændighed. Mange gange er kristne kampveteraner dybere bevidste om deres syndige tilstand end andre kristne. De føler sig måske uværdige over for Guds kærlighed på grund af de ting militærtjeneste kræver af dem. Dem, der lider af bekæmpelse af PTSD, kan synes, at det er ekstremt svært at acceptere Guds tilgivelse. De kan pinse over beslutninger, de tog i de mange no-win-situationer, hvor de blev placeret under krig. De kan også have vedvarende tilbageblik på krigens grufulde realiteter samt konsekvent føle sig i høj alarm fra måneders levetid i livstruende situationer.

Uanset omstændighederne er der håb. Først og fremmest kommer det håb fra Gud.

Behandlingsprocessen bør indebære en kombination af fysisk, mental og åndelig helbredelse. Mange vil kræve professionel hjælp. For dem med kamprelateret PTSD er det sandsynligvis at foretrække at modtage hjælp fra en person med erfaring i behandling af kampspecifik PTSD. Der findes flere terapeutiske midler til PTSD, lige fra samtaleterapi (ofte kognitiv adfærdsterapi) til kognitiv oparbejdning til øjenbevægelse desensibilisering og oparbejdning (EMDR) og andre metoder. Medicin kan også hjælpe med at lindre symptomer. Bestemt er et netværk af support og mdashcounselors, læger, familiemedlemmer, præster, kirkesamfundet og mdash vigtigt i genoprettelsesprocessen. Den vigtigste støtte er naturligvis Gud, vores ultimative healer og rådgiver. David skrev: ”Fra jordens ender kalder jeg på dig, / jeg kalder, når mit hjerte sveder / leder mig til klippen, der er højere end mig. / For du har været min tilflugt, / et stærkt tårn mod fjenden ”(Salme 61: 2 & ndash3). Det er vores ansvar at udøve tro på Gud, at blive i Ordet, at råbe til Gud i bøn og at opretholde fællesskab med andre troende. Vi går til Gud i vores nød og gør brug af de ressourcer, han giver.

Dem, der lider af PTSD af enhver erfaring, bør erkende, at behandlingen vil tage tid, og det er okay. Nogle har sammenlignet dette med Paulus ’“ torn i kødet ”(2 Kor 12: 7 & ndash10). Gud tilbyder helbredelse, men i vejen og timingen finder han passende. I mellemtiden giver han tilstrækkelig nåde til at holde ud under strabadser. Torner er smertefulde, og PTSD er bestemt en stor torn. Men vi kan fortsætte med at gå til Gud og minde os selv om hans trofasthed (Klagesangene 3 1 Korinther 1: 4 & ndash9).

Sandhed er en vigtig komponent til at klare eller overvinde PTSD. Det er ekstremt vigtigt at minde sig selv om, at Gud elsker, tilgiver og værdsætter sit folk. Det er vigtigt at vide, hvem Gud siger, at vi er og definere os selv efter hans standarder frem for hvad vi har gjort, eller hvad der er gjort mod os. Vi behøver ikke identificere os som hverken offer eller gerningsmand. I Gud kan vi identificere os som et elsket barn (Rom 8:14 & ndash17 Efeserne 1: 3 & ndash6 1 Johannes 3: 1 & ndash3), forseglet i Helligånden (Efeserne 1: 13 & ndash14), tilgivet (Romerne 5 Efeserne 1: 7 & ndash10 1 Johannes 1: 8 & ndash9 ) og indløses. At miste en nær ven eller et familiemedlem er utroligt svært, og mange kan føle sig uværdige til at blive skånet. Men dem med "overlevendes skyld" kan huske sandheden om Guds suverænitet, og at han har et formål med alles liv. Gud elskede dem, der var ofre i krig eller anden kriminalitet eller tragedie, lige så meget som han elsker dem, der overlevede. Hans formål med hver person er unikt. Det er vigtigt at erstatte løgnen om, at vi er uværdige at have levet med sandheden om, at Gud har en plan og værdsætter vores dage på jorden (Efeserne 2:10 5:15 og ndash16).

Det er også vigtigt at tale sandhed om praktiske ting. Ofte vil personer med PTSD føle sig truet, når situationen ikke berettiger det. Det er vigtigt at minde sig selv om, at dette ikke er den traumatiske begivenhed, men er en ny og sikker situation. Det er også vigtigt at tale sandt om, at PTSD ikke er en undskyldning for dårlig opførsel. Sandsynligvis vil PTSD bidrage til nogle negative tanke- og adfærdsmønstre. Dette er forståeligt, men det bør modstås.

At have et støttefællesskab, der tilbyder nåde og tilgivelse og taler sand i kærlighed, er utrolig vigtigt. Og det er vigtigt, at det samfund, der støtter den, der lider af PTSD, også modtager støtte. At forblive forbundet med sin lokale kirke er afgørende. Tid med Gud gennem bøn og læsning af hans ord er vigtig for både den, der lider af PTSD og hans eller hendes familie. Selvomsorg og at gøre ting, der er afslappende og forfriskende, er også vigtigt. PTSD føles ofte som om det overhaler ens liv. At gøre ting, der er underholdende og livgivende, er lige så vigtigt som at konfrontere PTSD direkte.

PTSD er en vanskelig udfordring, der kræver stærk tro på Gud og vilje til at blive ved. Men Gud er trofast, og hver dag kan vi vælge at overgive os til Guds kærlighed, bekæmpe PTSD så godt vi kan og i sidste ende hvile i Guds nåde og medfølelse. PTSD er ikke noget at ignorere, men noget at vende sig til Gud og aktivt engagere sig i. Vi inviteres til at frimodigt nærme sig Gud og udøse vore hjerter for ham (Hebræerne 4: 14 & ndash16). Vi er sikre på, at intet kan skille os fra hans kærlighed (Rom 8: 35 & ndash38). Gud kan genoprette den psykiske sundhed hos den PTSD -ramte. I sidste ende kan Gud endda bruge situationen til sin ære. “Lovet være vor Herre Jesu Kristi Gud og Fader, barmhjertighedens Fader og al trøsts Gud, som trøster os i alle vores problemer, så vi kan trøste dem, der er i problemer, med den trøst, vi selv modtager fra Gud . For ligesom vi har en stor del af Kristi lidelser, så er også vores trøst rig ved Kristus ”(2 Korinther 1: 3 & ndash5).


Er der tegn på PTSD i gamle krigerkulturer?

Jeg tænkte især på spartanerne, romerne og/eller vikingerne. Påvirker det at blive opvokset omkring vold og en krigerkultur PTSD -udvikling? Jeg er nysgerrig på, om det er et problem mellem natur og pleje. Er vi som mennesker tilbøjelige til at have det dårligt med krig, eller ændrer det sig at blive opvokset i en kultur, der er baseret i kamp?

Jeg ville elske at høre dine tanker. Tak skal du have.

Jeg kan udvide lidt om den romerske situation.

Som følge af Rosemary85 's indlæg er der også Cæsar i Vietnam: Lider romerske soldater af posttraumatisk stress? hvilket desværre er betalingsmuret, medmindre du har institutionel adgang.

Tanken i dette indlæg er hendes. Så husk på, at der vil være modstridende meninger, dette er kun et papir. Men jeg finder hendes papir informativt og sandsynligt, så jeg synes, det er værd at dele.

Vi har en tendens til at antage, at de gamle må have haft en eller anden form for traumer efter krigen, men er dette berettiget? Vi må ikke glemme, at mængden af ​​dagligdags vold, som (i det mindste byboere) oplevede i den antikke verden, var betydeligt mere, end vi oplever. Spillene kommer til at tænke på, hvor død og blodsudgydelse var almindelig. Men selvfølgelig kan traumer ofte kun opstå, når det er din livet på linjen. Vi skal være forsigtige med at oversætte den antikke verden til det moderne: der er ikke en en-til-en kortlægning.

Et andet problem er begrænsning eller forudindtagelse af kilder: Romerske historikere var generelt ikke interesseret i den almindelige soldat (medmindre de blev sure) - hvad der betød noget for dem om kampe var, hvem der var 'right ', hvem der vandt og hvem der tabte. Dem, de skrev om, var lederne, generelt senatoriske, for hvem krig var en del af at være aristokrat (det ændrede sig naturligvis over tid). Så beviser er noget begrænsede til at basere en diagnose

Der er også dette (s. 217):

En komplicerende faktor ved afgørelsen af, om romerne oplevede PTSD er, at diagnosen og specifikke udløsere af lidelsen ikke er fuldt ud forstået

Hvad vi dog ved, er, at PTSD er stærkt forbundet med hjernerystelse (s. 218-9), og disse var meget sjældnere i romertiden - udelukkende banker på hovedet - fordi romerne ikke kastede morterer mod hinanden . Der er mistanke om en sammenhæng mellem hjerneskade og PTSD - det er muligvis ikke helt psykologisk.

Chancen for at støde på triggerhændelserne for PTSD - og bevidne forfærdelige hændelser og/eller være i livsfare og/eller at begå drab & s (s. 217) var der, så der var sandsynligvis et baseline -niveau for PTSD, men ikke de niveauer, vi se i dag på grund af det relativt begrænsede antal hjernerystelse.

Vi skal også kaste kulturelle faktorer i blandingen: livet var brutalt, militærets position var anderledes, livet var tættere på døden i Rom - de samtidige eksempler, vi har på PTSD, er hos personer med et meget mere beskyttet liv. Romerne har måske lige trukket på det.

TLDR: vi vil sandsynligvis aldrig vide, om romerne havde PTSD, men der er gode grunde til at tro, at prisen, hvis nogen, var betydeligt lavere end i moderne tid.

CITE: AISLINN MELCHIOR (2011). Cæsar i Vietnam: Lider romerske soldater af posttraumatisk stresslidelse ?. Grækenland og Rom, 58, s. 209-22


Ville romerske soldater lide af ptsd?

Jeg spørger, fordi da jeg tænkte på dette, ser det ud til, at drab måske ikke har set så ondt eller ondt i den antikke verden, som det doserer i dag, især i kamp. Så ville de være mere vant til at dræbe og ikke blive så negativt påvirket af det. Men ville de have lidt af at se der venner dræbt i kamp eller måske af at brænde en landsby eller noget i retning af doselinjer

Jeg tror, ​​at denne video diskuterer dette spørgsmål.

Jeg tror, ​​der ligger en vis mulighed, ja. Du skal huske på, at romerne havde titusinder af soldater, der stod til deres rådighed, villige til at give deres liv af for deres imperium. Så at slå et andet menneske ihjel var sandsynligvis ikke så vild med dem, men jeg var sikker på, at der var mange, der gjorde det af loyalitet og frygt og senere indså, at det ikke var det værd at kæmpe for Rom, og heller ikke havde den død, de forårsagede. Det er i hvert fald hvad jeg synes.

At dræbe virkede måske ikke som & quotbad eller ondt & quot; men det betyder ikke, at PTSD blev reduceret på grund af det. Mange af kommentarerne her ser ud til at fokusere på forskellen i kultur, men PTSD diskriminerer ikke i alle kulturer. Det er en lidelse forårsaget af traumatiske begivenheder som krig, som var rigelig i den romerske periode. Hvis du ser på lidelsen fra et psykologisk synspunkt, har den altid eksisteret, men blev ikke korrekt diagnosticeret før det 20. århundrede. Der er rapporter om britiske og franske riddere, der lider af mareridt, følelsesløshed eller tilbageblik. Jeg kan huske, at jeg læste en beretning om, hvordan sølvtøjets klang var nok til at udløse en episode, da det mindede soldaten om sværd, der hang sammen. Jeg forstår ikke, hvordan romerne ville have været immun mod en sådan lidelse, da selv de mest hærdet soldater kan udvikle PTSD.

Handlingen med at dræbe ville faktisk være en mere førstehåndsoplevelse som romersk soldat. Du kiggede ofte i fjendens øjne, mens du stak ham og mærkede friktion af jern på kød gennem håndtaget. Sår ville være hyppigere, ligesom unødig grusomhed ville være. Statistisk set tager døden mere tid fra pile og spyd end fra kugler og granater, så du vil høre meget mere skrig af smerter og mennesker, der lider med lidt eller ingen lægehjælp.

Det eneste, der kan gøre ældgammel krigsførelse til en mindre årsag til ptsd end moderne krigsførelse, er bombardementer og drab. Måske også flydykning. Generelt giver skydning af en person langvejsfra ikke det samme quotshock som at dræbe ham med dine hænder, efter at du havde mistet dit våben eller dit skjold.

Så min mening er, at moderne krigsførelse ptsd ofre har det lidt bedre med hensyn til shellshock.

Kampe ville også vare langt mindre, og der var ingen skjulte sprængstoffer, der truede dig. Der var heller ikke konstant artilleriild. Jeg vil sige, at moderne ofre har det meget værre.

Jeg tror, ​​du har taget det hele forkert. I oldtiden var krig en integreret del af mandens liv. En god borger forventedes at være en god soldat, og hvis du menes at være en kriger fra det lille, tror jeg ikke, at du har et for stort problem med krigsførelse. Husk også på, at Rom blev set af dets samtidige som et fanatisk militaristisk samfund, der ikke førte & quotnormal & quot krig, hvor du stævner for fred efter et katastrofalt nederlag.

Tja, det var det, jeg troede, det var et samfund, hvor krig var noget, der bragte ære og berømmelse, ikke som verdenskrigene, hvor ingen virkelig ny, hvad man kan forvente

Så min mening er, at moderne krigsførelse ptsd ofre har det lidt bedre med hensyn til shellshock.

Ingen måde dude, i hvert fald ikke når det kommer til det shellshock, du bringer. At blev så slemt, at de mennesker, der blev berørt af det, nogle gange ville blive bogstaveligt talt så vanvittige, at de ikke længere kunne gå ordentligt. Muligvis fordi den konstante, utroligt ekstreme stress, de var under, til sidst beskadigede deres hjerner.

Men behandlingen til det var bare at rotere folk, så de ikke var under denne intense stress i uger eller måneder ad gangen. Nøglen her er den store mængde tid, hvor folk var stressede, noget, der er særligt for moderne krigsførelse, hvor du pludselig kan blive dræbt når som helst uden varsel. I Storm af stål, Ernst Jünger beskrev en scene, hvor hans firma på et tidspunkt bare sidder og derefter det næste øjeblik, uden advarsel, pludselig er halvdelen af ​​dem døde for en morter eller hvad det nu var. Du kan forestille dig den absurde mængde af stress, dette sætter dig under, vel vidende - følelse det, dybt inde i dine knogler, unægteligt, at det er lige så sandt, som at solen står op i øst - det når som helst du dør måske pludselig, og der er ikke noget, du kan gøre ved det. Det var utrolige mennesker, der overhovedet var i stand til at være sunde under disse forhold.

Det er ting, folk ikke behøvede at håndtere i førmoderne krigsførelse. De bliver sandsynligvis stadig traumatiseret af at skulle dræbe mennesker i hånd-til-hånd-kamp- foboer trods alt at være slagmarkens gud - men jeg forestiller mig, at det er en helt anden slags traumer.

Det tætteste, du kommer på til noget lignende, ville sandsynligvis være den manøvrering, som gamle hære gjorde som en optakt til forlovelser. De kunne bruge uger på at løbe i hele terrænet på en eller anden måde for at få et ben på den anden for at fremkalde et engagement i deres egen favør. Jeg forestiller mig, at disse forhold, især under krigens tåge, kunne blive meget stressende i en meget lang periode. Ser stadig ikke, at det er i nærheden af ​​så slemt som moderne krigsførelse.

Der er en vis debat om dette blandt historikere. Som jeg forstår det, er teorien, at samfund, der belønnede drab højst sandsynligt, ikke ville have oplevet PTSD så ofte som moderne samfund, hvor der ikke er det samme belønningssystem. Selvfølgelig er der altid undtagelser, og selv Herodotus taler om en fyr, der blev blind i kamp, ​​men ikke led nogen tydelig skade. Jeg tror, ​​at der også er nævnt lignende tilfælde i romerske kilder (Cæsars skrifter og andre?).

Du skal også tage højde for måden, kampe blev udført på, og nærheden til fjenden. Det var meget mere visceralt og brutalt end moderne krigsførelse, men kan du virkelig fortælle det til en fyr, der sad i skyttegravene, dag ud og dag ind? Gamle kampe var overstået relativt hurtigt (medmindre det var en belejring) i sammenligning med at sige kampe i Den Store Krig.

Vi har ikke ændret os fysiologisk, men vi forstår heller ikke helt, hvordan hjernen fungerer, og hvordan den kan støbes af vores miljø. Men det, vi ved, tyder på, at hvis vi bliver opdraget på en bestemt måde, kan det, der kan være afskyeligt for en person, være normalt for en anden.

Min fornemmelse er ja, der var tilfælde af PTSD, men belønningssystemerne på plads (og andre faktorer selvfølgelig) negerede sandsynligvis noget af det, relativt set.

Jeg tror, ​​jeg hellere ville være romer, være i skyttegravene, når romerne, hvor de under beskydning kunne komme ind i stramme formationer som skildpadden, hvor de i første verdenskrig bare løb i det fri

Vi har ikke ændret os fysiologisk, men vi forstår heller ikke helt, hvordan hjernen fungerer, og hvordan den kan støbes af vores miljø.

Vi har måske den samme psykologiske grundlinje, men vi er meget anderledes psykologisk fra de mennesker, der levede før os. Vores hjerner ændrer sig afhængigt af deres miljø (nogle gange direkte observerbart, som når du lærer nogen at læse og skrive) og vores psykologi sammen med dem.

Tag som et eksempel et af de mere berømte eksperimenter med at undersøge resultaterne af opvækst i æreskulturer (http://www.simine.com/240/readings/Cohen_et_al_(2).pdf), hvor amerikanske sydboere reagerer anderledes end at blive stødt ind i og kaldet et & quotasshole & quot end nordboere gør. Det er ikke kun mennesker beslutter for at handle anderledes vil de have deres reaktioner længe før de havde haft tid til at tænke over, hvordan de skulle reagere. Hele deres kroppe vil reagere forskelligt på situationen, en fyrs krop vil have aktiveret (og derefter undertrykt) alle udløsere til en kamp, ​​mens den anden fyrs krop vil vinde.

Hvorfor reagerer de anderledes? Fordi de har en anden psykologi - forskellige hjerner og kroppe - som følge af at være vokset op i en anden kultur.

Så jeg synes, at det er yderst naivt for historikere at tale om mennesker fra andre tider og kulturer, som om de var de samme som os. Ja, i den forstand at hvis de blev opvokset i vores samfund, eller vi i deres, ville vi være de samme - men vi er ikke det samme efter at have været opvokset i forskellige samfund.

Hvor forskellige ville de dog have været? Hvem ved? Men vi ved godt, at det kan være ret ekstremt. For eksempel kan mennesker lære sig selv at nyde smerte, sandsynligvis den bedste demonstration af vores formbarhed. Det kanoniske eksempel er krydret mad, som mennesker automatisk hader (som om de hader al smerte), men som de kan lære sig selv at nyde i stedet ved bogstaveligt talt at koble hjernen igen. Selvfølgelig er der mange andre eksempler. En anden sund (da krydret mad kan være sund) ville være at lære at nyde smerten ved at træne. En mindre sund kan være selvskadende.

Eller sammenlign mennesker i dag, der vil bryde ud i gråd ved synet af en hund, der dør i en film, med mennesker for bare et par hundrede år siden (og måske endda nogle mennesker i dag), der troede på, at dyr ikke engang kunne føle smerte. Eller sammenlign vores moderne mennesker med nutidens kinesere, der ganske gladelig hober krop efter stadig levende krop af hunde oven på hinanden efter at have flået dem levende de forvirrede, lidende dyr ' klynkende faldende på døve ører. Tror du, du kunne gøre det? Det kunne jeg ikke. Men hvis jeg voksede op i det samfund og havde forskellige forestillinger om dyr og deres lidelse, og om hunde i særdeleshed, ville jeg formodentlig kunne. Og hvis jeg voksede op i en kultur, der betragtede endda menneskelig lidelse meget anderledes end hvordan vi gør (f.eks. Lærer det mig at ignorere din lidelse totalt, hvis du ikke er en del af min gruppe), ville jeg også reagere meget forskelligt på det.

Alligevel. Pointen er, vi faktisk har ændret sig psykologisk, og det kunne let strække sig til at kunne udholde det, vi i dag vil kalde traumer - men som de måske ser på som trivielt eller endda normalt, og så ville de ikke blive traumatiseret af det. Jeg ville nok blive traumatiseret af at se nogen dø foran mig. Men hvis du allerede har set, at et dusin gange lige er vokset op? Når du har været vidne til flere lemlæstelser, flere kampe end du kan huske - nogle gange til døden - og endda har set folk blive henrettet offentligt til jubel og festligheder? Sandsynligvis ikke så traumatiserende. Måske endda lidt sjovt, at din hjerne har genforbundet sig selv for at nyde, hvad den ellers ikke ville: Tilpasse sig sit miljø.


Fra shell-shock til PTSD, et århundrede med usynlige krigstraumer

I kølvandet på 1. verdenskrig vendte nogle veteraner såret tilbage, men ikke med åbenlyse fysiske skader. I stedet lignede deres symptomer dem, der tidligere havde været forbundet med hysteriske kvinder - oftest hukommelsestab eller en form for lammelse eller manglende evne til at kommunikere uden nogen klar fysisk årsag.

Den engelske læge Charles Myers, der skrev det første papir om "shell-shock" i 1915, teoretiserede, at disse symptomer faktisk stammede fra en fysisk skade. Han fremførte, at gentagen eksponering for hjernerystelse forårsagede hjernetraumer, der resulterede i denne mærkelige gruppering af symptomer. Men når han først blev testet, holdt hans hypotese ikke op. Der var masser af veteraner, der ikke havde været udsat for de konkussive eksplosioner af skyttegravskrig, for eksempel, der stadig oplevede symptomerne på skalchok. (Og bestemt ikke alle veteraner, der havde set denne form for kamp, ​​vendte tilbage med symptomer.)

Vi ved nu, at det, disse kampveteraner stod over for, sandsynligvis var det, vi i dag kalder posttraumatisk stresslidelse eller PTSD. Vi er nu bedre i stand til at genkende det, og behandlingerne er bestemt gået frem, men vi har stadig ikke en fuld forståelse for, hvad PTSD er.

Det medicinske samfund og samfundet som helhed er vant til at lede efter den mest simple årsag og kur mod enhver given lidelse. Dette resulterer i et system, hvor symptomer opdages og katalogiseres og derefter matches med terapier, der vil lindre dem. Selvom denne metode virker i mange tilfælde, har PTSD i de sidste 100 år været imod.

Vi er tre forskere inden for humaniora, der individuelt har studeret PTSD - de rammer, hvorigennem mennesker konceptualiserer det, måder forskere undersøger det, de terapier, som det medicinske samfund udtænker til det. Gennem vores forskning har vi hver især set, hvordan den medicinske model alene ikke i tilstrækkelig grad redegør for den stadig skiftende karakter af PTSD.

Det, der mangler, er en sammenhængende forklaring på traumer, der giver os mulighed for at forklare de forskellige måder, dets symptomer har manifesteret sig over tid og kan variere i forskellige mennesker.

Ikke -fysiske konsekvenser af den store krig

Da det blev klart, at ikke alle, der led af skalleskok i kølvandet på WWI, havde oplevet hjerneskader, gav British Medical Journal alternative ikke-fysiske forklaringer på dets udbredelse:

En dårlig moral og en defekt træning er en af ​​de vigtigste, hvis ikke de vigtigste etiologiske faktorer: også at skalchok var en "fangende" klage. - (The British Medical Journal, 1922)

Shell-shock gik fra at blive betragtet som en legitim fysisk skade til at være et tegn på svaghed, for både bataljonen og soldaterne i den. En historiker anslår, at mindst 20 procent af mændene udviklede shell-shock, selvom tallene er grumsede på grund af lægens tilbageholdenhed på det tidspunkt med at mærke veteraner med en psykologisk diagnose, der kan påvirke handicapkompensation.

Soldater var arketypisk heroiske og stærke. Da de kom hjem ude af stand til at tale, gå eller huske uden nogen fysisk grund til disse mangler, var den eneste mulige forklaring personlig svaghed. Treatment methods were based on the idea that the soldier who had entered into war as a hero was now behaving as a coward and needed to be snapped out of it.

Electric treatments were prescribed in psychoneurotic cases post-WWI. Photo via Otis Historical Archives National Museum of Health and Medicine

Lewis Yealland, a British clinician, described in his 1918 “Hysterical Disorders of Warfare” the kind of brutal treatment that follows from thinking about shell-shock as a personal failure. After nine months of unsuccessfully treating patient A1, including electric shocks to the neck, cigarettes put out on his tongue and hot plates placed at the back of his throat, Yealland boasted of telling the patient, “You will not leave this room until you are talking as well as you ever did no, not before… you must behave as the hero I expect you to be.”

Yealland then applied an electric shock to the throat so strong that it sent the patient reeling backwards, unhooking the battery from the machine. Undeterred, Yealland strapped the patient down to avoid the battery problem and continued to apply shock for an hour, at which point patient A1 finally whispered “Ah.” After another hour, the patient began to cry and whispered, “I want a drink of water.”

Yealland reported this encounter triumphantly – the breakthrough meant his theory was correct and his method worked. Shell-shock was a disease of manhood rather than an illness that came from witnessing, being subjected to and partaking in incredible violence.

Evolution away from shell-shock

The next wave of the study of trauma came when the Second World War saw another influx of soldiers dealing with similar symptoms.

It was Abram Kardiner, a clinician working in the psychiatric clinic of the United States Veterans’ Bureau, who rethought combat trauma in a much more empathetic light. In his influential book, “The Traumatic Neuroses of War,” Kardiner speculated that these symptoms stemmed from psychological injury, rather than a soldier’s flawed character.

Work from other clinicians after WWII and the Korean War suggested that post-war symptoms could be lasting. Longitudinal studies showed that symptoms could persist anywhere from six to 20 years, if they disappeared at all. These studies returned some legitimacy to the concept of combat trauma that had been stripped away after the First World War.

UNDATED FILE PHOTO – A US Marine on a combat-reconnaissance mission during the Vietnam war crouches down as the Marines moved through low foliage in the Demilitarized Zone Photo via Reuters

Vietnam was another watershed moment for combat-related PTSD because veterans began to advocate for themselves in an unprecedented way. Beginning with a small march in New York in the summer of 1967, veterans themselves began to become activists for their own mental health care. They worked to redefine “post-Vietnam syndrome” not as a sign of weakness, but rather a normal response to the experience of atrocity. Public understanding of war itself had begun to shift, too, as the widely televised accounts of the My Lai massacre brought the horror of war into American living rooms for the first time. The veterans’ campaign helped get PTSD included in the third edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-III), the major American diagnostic resource for psychiatrists and other mental health clinicians.

The authors of the DSM-III deliberately avoided talking about the causes of mental disorders. Their aim was to develop a manual that could simultaneously be used by psychiatrists adhering to radically different theories, including Freudian approaches and what is now known as “biological psychiatry.” These groups of psychiatrists would not agree on how to explain disorders, but they could – and did – come to agree on which patients had similar symptoms. So the DSM-III defined disorders, including PTSD, solely on the basis of clusters of symptoms, an approach that has been retained ever since.

This tendency to agnosticism about the physiology of PTSD is also reflected in contemporary evidence-based approaches to medicine. Modern medicine focuses on using clinical trials to demonstrate that a therapy works, but is skeptical about attempts to link treatment effectiveness to the biology underlying a disease.

Today’s medicalized PTSD

People can develop PTSD for a number of different reasons, not just in combat. Sexual assault, a traumatic loss, a terrible accident – each might lead to PTSD. The U.S. Department of Veterans Affairs estimates about 13.8 percent of the veterans returning from the wars in Iraq and Afghanistan currently have PTSD. For comparison, a male veteran of those wars is four times more likely to develop PTSD than a man in the civilian population is. PTSD is probably at least partially at the root of an even more alarming statistic: Upwards of 22 veterans commit suicide every day.

Therapies for PTSD today tend to be a mixed bag. Practically speaking, when veterans seek PTSD treatment in the VA system, policy requires they be offered either exposure or cognitive therapy. Exposure therapies are based on the idea that the fear response that gives rise to many of the traumatic symptoms can be dampened through repeated exposures to the traumatic event. Cognitive therapies work on developing personal coping methods and slowly changing unhelpful or destructive thought patterns that are contributing to symptoms (for example, the shame one might feel at not successfully completing a mission or saving a comrade). The most common treatment a veteran will likely receive will include psychopharmaceuticals – especially the class of drugs called SSRIs.

Iraq war veteran Troy Yocum walks across the George Washington Bridge from New Jersey to New York accompanied by a Port Authority of New York and New Jersey color guard June 15, 2011.Yokum is hiking over 7,000 miles across America to raise awareness about the severe problems U.S. military families face due to soldiers returning home from overseas deployment with Post Traumatic Stress Disorder (PTSD), and to raise funds to help military families in need. Photo By Mike Segar/Reuters

Mindfulness therapies, based on becoming aware of mental states, thoughts and feelings and accepting them rather than trying to fight them or push them away, are another option. There are also more alternative methods being studied such as eye movement desensitization and reprocessing or EMDR therapy, therapies using controlled doses of MDMA (Ecstasy), virtual reality-graded exposure therapy, hypnosis and creative therapies. The military funds a wealth of research on new technologies to address PTSD these include neurotechnological innovations like transcranial stimulation and neural chips as well as novel drugs.

Several studies have shown that patients improve most when they’ve chosen their own therapy. But even if they narrow their choices to the ones backed by the weight of the National Center for PTSD by using the center’s online Treatment Decision Aid, patients would still find themselves weighing five options, each of which is evidence-based but entails a different psychomedical model of trauma and healing.

This buffet of treatment options lets us set aside our lack of understanding of why people experience trauma and respond to interventions so differently. It also relieves the pressure for psychomedicine to develop a complete model of PTSD. We reframe the problem as a consumer issue instead of a scientific one.

Thus, while WWI was about soldiers and punishing them for their weakness, in the contemporary era, the ideal veteran PTSD patient is a health care consumer who has an obligation to play an active role in figuring out and optimizing his own therapy.

As we stand here with the strange benefit of the hindsight that comes with 100 years of studying combat-related trauma, we must be careful in celebrating our progress. What is still missing is an explanation of why people have different responses to trauma, and why different responses occur in different historical periods. For instance, the paraylsis and amnesia that epitomized WWI shell-shock cases are now so rare that they don’t even appear as symptoms in the DSM entry for PTSD. We still don’t know enough about how soldiers’ own experiences and understandings of PTSD are shaped by the broader social and cultural views of trauma, war and gender. Though we have made incredible strides in the century since World War I, PTSD remains a chameleon, and demands our continued study.

Denne artikel blev oprindeligt offentliggjort på The Conversation. Read the original story here.


The psychological cost of warfare in the ancient world

Then said Achilles, "Son of Atreus, king of men Agamemnon, see to these matters at some other season, when there is breathing time and when I am calmer. Would you have men eat while the bodies of those whom Hector son of Priam slew are still lying mangled upon the plain? Let the sons of the Achaeans, say I, fight fasting and without food, till we have avenged them afterwards at the going down of the sun let them eat their fill. As for me, Patroclus is lying dead in my tent, all hacked and hewn, with his feet to the door, and his comrades are mourning round him. Therefore I can think of nothing but slaughter and blood and the rattle in the throat of the dying." - Iliad 19.226

As some of you know, I am the spouse of a veteran who has suffered from PTSD since service in Vietnam back in 1967-68. Although the psychological trauma suffered by those who have experienced a traumatic event now has a very modern-sounding diagnosis, it is not a recent phenomenon but has been a plague upon mankind, probably since men began engaging in warfare to wrest the territory or possessions from a competing group or avenge the losses incurred in such actions.

Some scholars have proposed PTSD is a modern phenomenon brought on by the use of explosive weapons like IEDs, land mines, or booby traps and the concussions that resulted from their use.

In her paper, Caesar in Vietnam: Did Roman Soldiers Suffer from Post-Traumatic Stress Disorder?, classicist Aislinn Melchior admits that concussion is not the only risk factor for PTSD but says it is so strongly correlated that it suggests the incidence of PTSD may have risen sharply with the arrival of gunpowder, shells, and plastic explosives.

"In Roman warfare, wounds were most often inflicted by edged weapons. Romans did of course experience head trauma, but the incidence of concussive injuries would have been limited both by the types of weapons they faced and by the use of helmets," Melchior observes. Melchior also speculates that death was so common in the ancient world that it desensitized many of its residents to the prospect of unexpected death.

But in his 1999 paper entitled "The Cultural Politics of Public Spectacle in Rome and the Greek East in 167-166 BCE" Jonathan C. Edmondson points out that when King Antiochus IV introduced Roman-style gladiatorial combats in Syria in 166 BCE, the Syrians were terrified rather than entertained.

"In time gladiatorial contests came to be accepted and even popular, but only after Antiochus had instituted a local variation whereby fights sometimes ended as soon as a gladiator was wounded."

This hardly sounds like people desensitized to death.

Recently, scholars studying cuneiform medical texts left behind by ancient Mesopotamians point to passages describing mental disorders expressed by soldiers and even a king during the Assyrian Period (1300� BCE) when military activity was extremely frequent and brutal. The King of Elam is said to have had his mind changed. Soldiers were described as suffering from periods where they were forgetful, their words were unintelligible, they would wander about, and suffer regular bouts of depression.

I also think scholars dismiss too readily the psychological aspects of PTSD in the ancient world because of their observations that the ancient world was a far more brutal environment than we have now (outside of inner city ghettos). They point out how people were surrounded by death because of disease, accidents without proper medical treatment, and entertainments that featured the orchestrated deaths of both people and animals. I propose that observed deaths occurring in a venue where the observer and the participants are separated both by physical barriers and social hierarchy (most human victims were criminals, prisoners of war, "Others" so to speak, or slaves, those whose social status separated them from the vast number of citizens in the audience) are distinctly different when compared to violent deaths of friends, family members, and comrades, your "band of brothers," fighting right beside you in a person-to-person battle scenario.

Furthermore, ancient executions were designed to further distance the audience from the victim through the use of mythological reenactments or by placement outside the city.

"Crucifixions were usually carried out outside the city limits thus stressing the victims rejection from the civic community. Because of the absence of bloodshed out of an open and lethal wound, which evoked the glorious fate of warriors, this type of death was considered unclean, shameful, unmanly, and unworthy of a freeman. In addition the victim was usually naked. Essential, too, was the fact that the victim lost contact with the ground which was regarded as sacrilegious." - J.J. Aubert, "A Double Standard in Roman Criminal Law?" from "Speculum Juris: Roman Law as a Reflection of Social and Economic Life in Antiquity"

We also cannot forget the medical personnel either. The medical environment of an ancient treatment facility following a major battle was far worse than in a modern field hospital. Ancient surgeons attempted to treat often thousands of wounded in a relatively short time compared to only handfuls at a time during the Vietnam conflict. Ancient physicians were surprisingly quite skilled, especially Roman military surgeons, but they had little but herbal compounds (and honey if the Romans listened to the Egyptian physicians) to ward off infections. Their patients' mortality rate was much higher than the relatively low mortality rate experienced in Vietnam.

I sometimes wonder, though, if modern scholars think that ancient people just didn't value their lives as much as we do, since they did not shrink from casualties as high as 50,000 in a single military engagement or investment of an enemy city. But if you've ever looked at some of the poignant grave goods found in ancient burials or studied the reliefs and inscriptions on ancient funerary monuments, I think you will conclude that we are only separated by time, not by our shared human nature.

This post is a condensed summary of a paper I wrote, "Concussion and PTSD in the Ancient World" back in 2013. You can read the full article at:


Shell-shock

Soldiers described the effects of trauma as “shell-shock” because they believed them to be caused by exposure to artillery bombardments. As early as 1915, army hospitals became inundated with soldiers requiring treatment for “wounded minds”, tremors, blurred vision and fits, taking the military establishment entirely by surprise. An army psychiatrist, Charles Myers, subsequently published observations in the Lancet, coining the term shell-shock. Approximately 80,000 British soldiers were treated for shell-shock over the course of the war. Despite its prevalence, experiencing shell-shock was often attributed to moral failings and weaknesses, with some soldiers even being accused of cowardice.

An Australian soldier displaying signs of shell-shock (bottom left) Wikimedia Commons

But the concept of shell-shock had its limitations. Despite coining the term, Charles Myers noted that shell-shock implied that one had to be directly exposed to combat, even though many suffering from the condition had been exposed to non-combat related trauma (such as the threat of injury and death). Cognitive and behavioural symptoms of trauma, such as nightmares, hyper-vigilance and avoiding triggering situations, were also overlooked compared to physical symptoms.

Today, it is these cognitive and behavioural symptoms that define PTSD. The physical symptoms that defined shell-shock are often consequences of these nonphysical symptoms.


Every war, WWII included, has scarred its combatants’ psyches. Yet there remain those who look back fondly at the good old days of armed conflict, when iron-nerved men’s men simply shrugged off the tribulations of the battlefield. One might reasonably file such a misty-eyed take under the heading of nostalgia—a term, it so happens, that was coined in the 17th century to describe a mysterious ailment afflicting Swiss soldiers, making it the first medical diagnosis of war’s psychological effects. Many other names would be proposed for this condition over the years before the American Psychiatric Association put it in the books as post-traumatic stress disorder in 1980. The symptoms, though, have remained consistent: PSTD sufferers relive traumatic events, avoid situations that bring them to mind, endure negative feelings about themselves and others, and generally feel anxious and keyed-up.

No psych evals were conducted during the Trojan War, of course, but the U.S. Department of Veterans Affairs site finds literary antecedents for PTSD symptoms in Homer, Shakespeare, Dickens, and Stephen Crane. And mercenaries from the Alps stationed in the European lowlands had been suffering from bouts of anxiety and insomnia for some time before the Swiss doctor Johannes Hofer named their disorder “nostalgia” in 1688. Apparently stricken with a longing for their far-off homes (often triggered by the melodies of traditional cow-herding songs), these otherwise sturdy fellows supposedly fainted, endured high fevers and stomach pain, and even died. But though physicians now had a name for it, they lacked a cause—maybe the clanging of those infernal cowbells had damaged Swiss brains and eardrums, some suggested—and for treatment they fell back on standard remedies of the pre-ibuprofen era, e.g. leeches and opium.

During our own grisly Civil War, soldiers’ anxiety expressed itself in palpitations and difficulty breathing, a condition dubbed “irritable heart” or “soldier’s heart.” Some researchers, scrambling to find a physical mechanism behind the symptoms, blamed the way the troops wore their knapsacks, while the high-minded saw a spiritual failing—sufferers were seen as oversexed and prone to masturbation. Dr. John Taylor of the Third Missouri Cavalry expressed “contempt” for these soldiers’ “moral turpitude,” saying “gonorrhea and syphilis were not more detestable.” Classified (if not wholly understood) as “Da Costa’s syndrome” after the war, based on 1871 findings by Jacob Mendez Da Costa, the condition was treated with drugs to lower the heart rate.

The term “shell shock” came into use during the Great War, born of the belief that mortar fire had psychologically disoriented the boys. With unending need for trench fodder, the warring nations simply shipped 65 percent of traumatized men back to the front the more serious cases received electrotherapy, hypnosis, pr hydrotherapy—essentially a relaxing shower or bath. The psychological effects of World War I were so widespread that when the sequel arose, military experts hoped to curtail what they called “combat stress reaction” with intense psychological screening of combatants, believing they could ID those most likely to suffer.

They couldn’t. “Battle fatigue” plagued soldiers in World War II. Hard-asses would equate this condition with cowardice or goldbricking, none more notoriously than General George S. Patton, who on two different occasions slapped and browbeat afflicted soldiers for seeking medical care. But the problem was too widespread to ignore—a conservative estimate is that 5 percent of WWII veterans suffered symptoms we’d associate with PTSD, and as late as 2004 there were 25,000 receiving benefits for war’s psychological aftereffects. Stats for Korean War vets are a little harder to come by, but over 30 percent of the veterans who responded to a 2010 Australian study met PTSD criteria, with or without accompanying depression.

By midcentury the U.S. Army had come around to the idea thatto quote the 1946 film Let There Be Light, John Huston’s army-produced documentary about the causes and treatment of mental illness during WWII—“every man has his breaking point.” Still, the psychiatric community struggled with how to conceptualize PTSD. Den første Diagnostic and Statistical Manual of Mental Disorders, from 1952, listed the condition as “gross stress reaction” again, it first appeared under its modern name only in 1980’s DSM-III, in part because of research on veterans returned from a war that wasn’t considered one of the “good” ones.

Thanks to this timing, PTSD will forever be connected with Vietnam vets, and in fact as many as 30 percent of them were diagnosed with symptoms at some point. But the numbers haven’t been much better for American conflicts since—between 15 and 20 percent. And, of course, civilians suffer as well. About 7 or 8 percent of all Americans will have PTSD at some point, though for women the number is closer to 10 percent. This presumably has less to do with any physiological differences between the sexes than with the greater likelihood of trauma, especially sexual assault, that women face. There are other kinds of hell than war. —Cecil Adams


Chris Kyle's PTSD: The untold, real-life "American Sniper" story

By John Bateson
Published February 19, 2015 11:28AM (EST)

Bradley Cooper in "American Sniper" (Warner Bros. Entertainment)

Aktier

In his best-selling memoir, "American Sniper: The Autobiography of the Most Lethal Sniper in U.S. Military History," published in 2012, Navy SEAL Chris Kyle writes that he was only two weeks into his first of four tours of duty in Iraq when he was confronted with a difficult choice. Through the scope of his .300 Winchester Magnum rifle, he saw a woman with a child pull a grenade from under her clothes as several Marines approached. Kyle’s job was to provide “overwatch,” meaning that he was perched in or on top of bombed-out apartment buildings and was responsible for preventing enemy fighters from ambushing U.S. troops. He hesitated only briefly before pulling the trigger. “It was my duty to shoot, and I don’t regret it,” he wrote. “My shots saved several Americans, whose lives were clearly worth more than that woman’s twisted soul.”

Kyle was credited with 160 confirmed kills—not only an astounding number but an indication that the U.S. military today still considers counting dead enemy something worth doing. Kyle was so good at his job that Iraqi insurgents nicknamed him the “Devil of Ramadi” and put a bounty on his head. They never collected, but the war took its toll anyway. Kyle, who learned to shoot a gun before he learned to ride a bike, saw the face of his machine gun partner torn apart by shrapnel, witnessed another comrade die when an enemy bullet entered his open mouth and exited the back of his head, and lost a third friend when an enemy grenade bounced off his chest and he jumped on it before it exploded in order to save everyone around him. Kyle also was among the many Marines who were sent to Haiti in 2010 to provide humanitarian relief following the devastating earthquake there. According to Nicholas Schmidle, whose lengthy profile of Kyle appeared in the New Yorker in June 2013, Kyle was overwhelmed by all the corpses in Haiti that were piled up on roadsides. He told his mother afterward, “They didn’t train me to go and pick up baby bodies off the beach.”

These and other experiences led to many sleepless nights when Kyle returned home, as well as days in which he lived in an alcoholic stupor. It didn’t help that in each of his sniper kills, Kyle could see through the lens on his rifle, “with tremendous magnification and clarity,” wrote Schmidle, his bullet piercing the skull of his target.

According to his medical records, Kyle sought counseling for “combat stress” after his third deployment. Like most soldiers, however, in his exit physical he said he had “no unresolved issues.”

Kyle longed to return to the war, to the world he knew the best, where everything made sense and he was in the company of others who understood him and appreciated his talents. His wife, however, said that if he reenlisted she would take their two young children and leave him. Trying to find a sense of purpose outside of combat, Kyle participated in various activities for veterans, primarily hunting trips. In addition, he started a company that provided security at the 2012 London Olympics, helped guard ships near Somalia from pirates, and served briefly as a bodyguard for Sarah Palin.

When Kyle was approached by the mother of a distressed 25-year-old Iraq War veteran named Eddie Ray Routh, who was suffering from PTSD and taking eight different medications, Kyle agreed to help. He told Routh that he, too, had had PTSD. In February 2013, Kyle and a friend drove Routh to a gun range near Kyle’s home in Texas. Kyle thought that shooting a firearm might offer some kind of therapy for Routh. Instead, Routh shot and killed both Kyle and his friend with a semiautomatic handgun before fleeing in Kyle’s pickup truck. Afterward, Routh told his sister that he killed the two men before they could kill him and that he didn’t trust anyone now.

From an outside perspective, it’s difficult to believe that a combat veteran like Routh would think he couldn’t trust one of the most revered soldiers in recent years, a man who gave his time freely to assist other veterans. Yet Routh learned from his training as well as from his own experiences in war that many people who seemed friendly or innocent really weren’t. While it’s rare for this distrust to include a soldier’s comrades, when one’s mind is warped by a combination of trauma and a cocktail of pharmaceuticals, nearly anything can happen. Seven thousand people, including Palin and her husband, attended Kyle’s memorial, which was held at Cowboy Stadium. Routh is now on trial for the two murders.

Killing others is morally reprehensible and a grievous sin. It’s also criminal, but not in war. In no other setting are people trained to kill on sight, no warnings issued or questions asked. The rule of thumb is to shoot first, and deal with any moral uncertainties later. As Tony Dokoupil notes, however, the word drab “doesn’t appear in training manuals, or surveys of soldiers returning from combat, and the effects of killing aren’t something that the military screens for when people come home.”

Excerpted from "The Last and Greatest Battle: Finding the Will, Commitment and Strategy to End Military Suicides" by John Bateson. Published by Oxford University Press. Copyright 2015 by John Bateson. Reprinted with permission of the publisher. Alle rettigheder forbeholdes.

John Bateson

John Bateson is the author of The Final Leap: Suicide on the Golden Gate Bridge. For more than 15 years he was executive director of a nationally certified suicide prevention center in the San Francisco Bay Area. He served on the steering committee of the National Suicide Prevention Lifeline and was part of a blue-ribbon committee that created the California Strategic Plan on Suicide Prevention.


War Veterans and Post Traumatic Stress Disorder (PTSD)

Those who survived a war, are often scarred for life by their experiences. Many suffer problems, including the condition known as Post Traumatic Stress Disorder (PTSD).

It took considerable time for the medical and mental health professions to connect the persistent symptoms of depression, anxiety, chronic insomnia, jumpy body movements, terrifying nightmares, inability to keep a job (resulting in living on the streets), aggressive behaviour, alcoholism, drug abuse, personality changes, difficulty with relationships, a rise in divorces, the high rate of imprisonment and an unacceptably high level of suicide amongst veterans of Vietnam and other war areas, to a disorder now known as Post Traumatic Stress Disorder.

PTSD was officially recognised in 1980 but it took years before it was more generally known and accepted as the debilitating disorder that it is – and while much work is being focused in this area – it is still not yet fully understood.

So many persons came home from war zones suffering from confusion, guilt, anger, shame and sorrow. Many of these persons simply could not cope with the awful burden of such intense feelings – hence the development of the symptoms listed above. PTSD is not easily recognised or treated since people react differently to traumatic stress and the effects of such stress cause a multitude of problems which effectively prevent the sufferer from pursuing a normal life.

The treatment of PTSD has changed radically and work is being done on many fronts to help such persons. Since each person reacts differently to stress, not everyone involved in war or other traumatic situations needs help. There are many veterans living perfectly normal lives. PTSD affects not only War Veterans, but ordinary citizens and even children. It can happen to anyone who has experienced major trauma in their lives, such as for example, as a result of an accident, assault, disaster or death.

Unfortunately, a huge number of vets suffer from some level of PTSD, which possibly explains the large percentage of veterans who are in jail. Shad Meshad (Founder of the National Veteran’s Foundation), himself a Vietnam veteran, noted that 2600 veterans were in the Californian Prison system out of a population of 13500 persons. He further noted that 22 suicides per day are committed by veterans. In order to help PTSD vets, Shad’s National Vet Foundation created a Live Chat website to allow veterans create their own support network.

Information is made available of where and how to get professional help and a Hotline is also available for those in dire need. Shad started counselling groups for Vets In Prisons (VIPs) where they could share their experiences. “Sneaky” James White – a vet who has been in prison since 1978, attended a VIP meeting and became so inspired that he began setting up VIP counselling groups wherever he was placed. He encouraged vets to share their troubles and fears and to support and listen to one another. He encouraged them to study further and to become counsellors themselves. Sneaky is much admired for his commitment to the improvement of the lives of all those around him.

Much is being done to help these PTSD sufferers – on many fronts. In the medical and psychological fields, new methods of treatment are being introduced and many are proving to be reasonably successful.

Psychotherapy, the most common approach, includes, among others, cognitive therapy (encourages improved ways of thinking) and exposure therapy (facing one’s fear) where sometimes Virtual Reality programmes are utilised. Another therapy is that of Eye Movement Desensitisation and Reprocessing (EMDR), which is aimed at helping to process traumatic memories so that they can be handled by the sufferer.

It has been found that sufferers often require more than one approach, so most therapies are used in conjunction with other therapies or methods. Many of the therapies need to utilise various drugs for the control of depression, anxiety, insomnia and nightmares.

Dr Kate Hendricks Thomas, a Marines Veteran and a Public Health researcher, is convinced that “pills and therapies are not enough to return this active, passionate community [marines and soldiers] to health after trauma” She had long struggled with her own problems before finding that a study of Yoga meditation was a solution for her. She had grown up in the military field and knew the life intimately. On returning from Vietnam she found herself fighting to control her physical aggression – to the point where she even had to hide her gun.

Her personal relationships were radically affected – so much so, that at one time she felt she could have appeared on a Jerry Springer show! She found that working towards the goal of creating mental fitness and resilience with yoga meditation and other techniques saved her life. She became a trained Yoga instructor and teaches Yoga methods to groups of veterans suffering from various forms of PTSD. She feels that these military persons, since they are so competitive, respond so much better to a challenge. As she could relate to their sufferings – she gained the trust of her students.

It appears that a number of PTSD practitioners can attest to the value of yoga and yoga-like meditation practices and techniques, having also noticed significant positive improvements in many of their patients.

A recent assessment seems to indicate that a large number of veterans with Post Traumatic Stress Disorder still suffer major depressive disorders and seem to be deteriorating rather than improving. This may well be due to aging, retirement, chronic illness and declining social security as well as the ongoing difficulties with the management of unwanted memories. Perhaps they too can be helped by practising meditation and breathing exercises.

More practitioners dealing with PTSD veterans seem to be favouring the multi-faceted approach, combining various therapies and techniques tailored to each individual’s particular symptoms and requirements. One is heartened to know that this multi-faceted approach is having great effect and thus gives us hope for the challenges that may well lie ahead with the veterans from Iraq and Afghanistan.