PTSD and the psychological toll of war
Most U.S. citizens have been largely insulated from the daily impact of our country’s wars in Afghanistan and Iraq. Now, as the nation grapples with the Fort Hood tragedy, we may find we can no longer ignore the psychic burdens that our soldiers must bear.
Major Nidal Malik Hasan, believed to have killed 13 people and wounded more than 30, is a psychiatrist who earned his medical degree from the Uniformed Services University in Bethesda, the Washington Post reports. Over the past six years, he interned and served as a resident at Walter Reed Army Medical Center, where he was a liaison between wounded soldiers and psychiatry staff. He was also a fellow at the Center of Traumatic Stress Study at Bethesda military school.
It’s “a hazy and contradictory picture,” a team of Washington Post writers observe. Major Hasan enlisted out of high school, “received his medical training from the military, and spent his career in the Army, yet allegedly turned so violently against his uniformed colleagues.” But it may not be as contradictory as it seems.
“Our troops do not enlist because they want to destroy or kill,” Ed Tick writes in “Sharing War’s Burden,” excerpted from Yes! in the Sept.-Oct. 2008 Utne Reader. Tick is a psychotherapist and the director of Soldier’s Heart, a return and healing project for veterans. Utne Reader named him a visionary in 2008 . “No matter the political climate, most troops seek to serve traditional warrior values: to protect the country they love, its ideals, and especially their families, communities, and each other.”
He continues: “In my work counseling veterans of several wars, I’ve seen that PTSD is, in part, the tortured conscience of good people who did their best under conditions that would dehumanize anyone.”
According to the New York Times, Major Hasan was “mortified” by the idea of having to deploy. “He had people telling him on a daily basis the horrors they saw over there,” cousin Nader Hasan tells Times writer James Dao. To put this burden in context, here’s a passage from our March-April 2009 story “The Life and Lonely Death of Noah Pierce,” excerpted from Virginia Quarterly Review. It chronicles an Iraq veteran’s suicide:
Noah Pierce’s headstone gives his date of death as July 26, 2007, though his family feels certain he died the night before, when, at age 23, he took a handgun and shot himself in the head. No one is sure what pushed him to it. He said in his suicide note it was impotence—one possible side effect of posttraumatic stress disorder (PTSD). It was “the snowflake that toppled the iceberg,” he wrote. But it could have been the memory of the Iraqi child he crushed under his Bradley. It could have been the unarmed man he shot point-blank in the forehead during a house-to-house raid, or the friend he tried madly to gather into a plastic bag after he had been blown to bits by a roadside bomb, or it could have been the doctor he killed at a checkpoint.
It is clear that it’s too early to surmise the complete story: Major Hasan, who was shot and injured, has not been interrogated; there were reports that he, who had grown a more devout Muslim since his parents’ deaths in 1998 and 2001, had been mocked by fellow servicepeople for his religion; and the London Times was linking to an Internet posting Hasan allegedly made comparing Islamist suicide bombers to American military heroes.
It is not, however, too early to at least imagine that being an individual assigned to help soldiers heal also would be an awesome strain in itself. There’s also no doubt that stress can exact its toll on someone who has yet to be deployed. In 2007, New Scientist reported on a little-publicized study that discovered that people can qualify for a PTSD diagnosis whether or not they have personally experienced trauma.
According to the American Psychological Association’s current guidelines, PTSD diagnosis is limited to someone who has personally experienced “actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others,” New Scientist reported. In the study, however, over three quarters of the patients who were known to be depressed but had not experienced trauma tested positive for PTSD.
A soldier’s stress can also be made worse by the debate swirling around whether or not a war is just. Most conventional therapies teach healers to avoid talk of morality, Tick notes, but war is inherently a moral enterprise. Additionally, PTSD can be “much more severe when there are moral and ethical questions involved—when the war itself is illegitimate,” he told Utne Reader editor in chief David Schimke, who wrote about their conversation in his Jan.-Feb. 2008 editor’s note, “A Soldier’s Heart.”
Tick sees a profound need for communities to step forward, to develop rituals and public dialogue around sharing and accepting the burden of war, transferring it from soldier to citizen. “When I go into veteran communities, I’m often the only progressive, nonveteran there talking with the vets,” Tick told Schimke. “This expresses a great divide in our society—how profoundly citizens and warriors are alienated from each other.”