PTSD in history, other cultures

[Ken White]

numbers can lead you astray. How many were in Theater; how many elsewhere in the world. How many in CONUS. Any combat tours? If so, how many? Where? What was the catalyst? Spousal problems? Money problems? Stress? Combat stress or other stress? How many male? How many Female?

IIRC, the current rate is still lower than the 19-25 non-military demographic in the US for males but higher for females. I also seem to recall reading somewhere that the in theater rate was lower than anyone expected and the majority were not in the two theaters.

Without detailed info, the raw number is borderline meaningless. The fact that it's the highest in 20 years is at least partly due to the fact that as a result of the surge the active duty end strength is higher than it has been in 20 years...

* That similarity is from memory (and I'm old, so it may be flaky). Not an issue to me but Google may be able to provide definitive numbers of a sort.

[Darksaga]

The National Institute of Mental Health defines PTSD as "an anxiety disorder that can develop after exposure to one or more terrifying events in which grave physical harm occurred or was threatened". What I would like to find out is the relationship between culture, the nature of modern war, and PTSD, if there is a significant relationship at all.

(1) Is PTSD prevalent in other cultures/countries? Is it a major issue primarily in industrialized countries, or is it present in all cultures engaged in conflict? Russia has a serious problem managing PTSD among combat veterans returning from Chechnya, but this would seem to indicate that PTSD is a consequence of industrialized war.

(2) Are there historical references to PTSD in history prior to modern warfare? How was it perceived and managed? Was it particular to certain cultures or present throughout the history of war? The Iliad makes a reference to what appears to be PTSD -- Ajax loses a duel, comes under a "spell" from Athena, slaughters a herd of sheep thinking they are the enemy, and then kills himself. Is this an ancient reference to PTSD? If so, it would seem, so far, that PTSD is a product of Western culture.

(3) If PTSD is particular to a certain cultural arch-type or form of warfare, is it therefore a product of social construction?

(4) If it's a social construct, would PTSD treatment be more effective by addressing the underlying cultural variables rather than specific individuals (not to say, of course, that those individuals suffering from it should be refused treatment on a case-by-case basis).

The first real description of PTSD like symptoms is read in the account of the aftermath of the Battle of Thermopalye.

PTSD is more than just a single or multiple experiences. PTSD can also be learned behavior that was positive at the time in that it allowed for survival but does not translate well when the individual returns to a "safe" environment. This learned behavior also has a physical presence where the fight or flight reaction is instaneous and bypasses normal though process.

PTSD treatment needs to be specific to the individual and the way each individual processes their experience is personal and unique. For some working through the issues in one on one counseling is key. With others the transition to group therapy is extremely important. Sometimes cognitive behavioral approach or reality therapy may be the model to use. In all truth there is no outright cure for PTSD. The focus of treatment is learning to live with it.

Frankly there is no one blanket treatment for PTSD either but it can be allieviated somewhat by the learning of new coping skills and with the stigma associated with it minimalized. The Army is making strides in this area by fielding Combat Stress Control Units to provide counseling and psychiatric care for soldiers and to debrief units after critical incidents.

[reed11b]

and I'd add that mental toughness and /or being mildly sociopathic helps as much or more...

Mental flexibility may be more accurate. PTSD appears to be a processing memory problem more then anything else at this point in time. There were a few references to the SF community and PTSD on this thread, however keep in mind that an SF trooper that is diagnosed w/ PTSD would lose his Top Secret clearance, and thus no longer be an SF trooper. This combined with the fantastic team support that SF enjoys likely has more to do with the lower SF PTSD rates then anything else. When question 21 is removed, I will be curious to see if SF reported PTSD rates go up. Army battlemind training is a fantastic tool btw, speaking of preventative measures. The military is making great strides and deserves recognition for there role in improving the care for everyone w/ PTSD. Army behavioral Health is tops in this field, better then the VA.
Reed
P.S. Adam L.'s comments on PTSD being a cluster of symptoms and that understanding of the root cause is scarce is true. Unfortunately the entire DSM-IV operates the exact same way. So singling out PTSD for this is a little irrational. Reminds me of continued attempts to peg ADD on bad parenting. PTSD exists and now we need to discover the root causes to the best of our ability.

[Jayhawker]

I have to be honest and say that I've not read it, but Roger Spiller, formerly a Prof at CGSC, thinks very highly of Ben Shephard's "A War of Nerves" Harvard Univ Press, 2001. Shephard focuses on 20th century soldiers so the book runs the gamut from WWI to the Faulklands and includes WWII Army Air Forces. Shephard "writes widely on psychiatry and its history," according to the book blurb.

Ben

[Tom Odom]

I have to be honest and say that I've not read it, but Roger Spiller, formerly a Prof at CGSC, thinks very highly of Ben Shephard's "A War of Nerves" Harvard Univ Press, 2001. Shephard focuses on 20th century soldiers so the book runs the gamut from WWI to the Faulklands and includes WWII Army Air Forces. Shephard "writes widely on psychiatry and its history," according to the book blurb.

Ben

That makes sense. Roger was and is very big on the mental aspects and effects of combat/war. Jerry Linderman is another I wouuld recommend.

Tom

[h2harris]

An interesting account of the after effects of battle is found in: "Reluctant Warriors - Israelis Suspended Between Rome and Jersualem" by Nathan Szajnberg (can be found on Amazon.Com). Dr. Szajnberg studed kibbutzniks enrolled in elite combat units of the IDF. The study focused on, "How do these citizen soldiers, residents in a democratic society, manage to be effective soldiers, yet maintain their humanity as men? How did their transitions from adolescence to young adulthood influence their inner lives, their views of life and the tense, tangled world in which they lived." The author, a psychoanalyst by profession, conducted a series of interviews during over two dozen trips during the Intifada.