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To the LA Times credit, they published an article, "Stress of combat reaches drone crews," by David Zucchino about the impact of combat stress (Post-Traumatic stress)  on the Air Force pilots who are remotely guiding drones. But the LA Times Editors cut a key section of the story, included in the original version by David Zucchino, that would have explained to readers that combat stress is caused, not just by the trauma of being shot at, but by the trauma of killing others.

The article as written sounds mystified about what might be causing their combat stress. The Stars and Stripes picked up the story, and many of the comments on the article dismissed the idea that these pilots could possibly be impacted by post-traumatic stress, since they are safe from being shot at. Unfortunately, many people in the military, and many veterans, aren't being informed about, or being helped to deal with, the psychological damage caused by inflicting injuries on and killing other people. The LA Times Editors, by cutting this section out of the article, are, at best, omitting information that could help hundreds of thousands of suffering veterans. It's hard to avoid speculating that the LA Times Editors cut this section in an attempt to sugar-coat the horrors of war.

Of course, the article also did not address the psychological impact on civilian populations of being hit by drones, but that's a topic for a different article. Here, I want to address: what I know about how the LA Times cut the article, the crucial impact that killing has on the suffering of veterans, especially those experiencing post-traumatic stress; the ways in which the DoD, the VA, and even the Institute of Medicine are also ignoring these findings; and the devastating impact of this neglect.

Trauma of Killing - Cut for Space?

I emailed the author of the LA Times article to complain about this omission. David Zucchino kindly wrote back, telling me, "My original story did indeed have a short section on the effects of killing, but it was edited out for space. So it goes in the ever-shrinking world of original journalism." (Zucchino authorized me to quote his email). Editing out the key section of an article that would go a long way to explaining the phenomenon described in the rest of the article sounds more like a political decision than a journalistic one. In journalistic editing, you're supposed to cut the material that is least important to the story, not the most salient insights.

Killing is a Major Contributor to Post-Traumatic Stress - But the Military Ignores this Reality

Dan Baum, in his award-winning article "The Price of Valor" in the New Yorker (pdf), describes the work of Lt. Col. Grossman, who wrote the book On Killing, The Psychological Cost of Learning to Kill in War and Society:

A military “conspiracy of silence” surrounds the topic, Grossman argues, because the Army hasn’t confronted the issue of how psychologically fraught is the killing that its soldiers are ordered to do. In “On Killing,” Grossman writes, “If society prepares a soldier to overcome his resistance to killing and places him in an environment in which he will kill, then that society has an obligation to deal forthrightly, intelligently, and morally with the psychological event.”
Grossman has argued with the military and the VA for years against neglecting this topic. Grossman's website is called killology.com.

Rachel MacNair analyzed data from Vietnam Veterans suffering from PTSD and coined the term PITS (Perpetration-Induced Traumatic Stress) in her book of the same name to explain her findings. On her website, she summarizes:

Even so, people were still thinking in terms of PTSD being caused entirely by being a victim of a trauma. The soldier was scared of being shot, the soldier was grieved over buddies being shot. The idea that the act of shooting could be traumatizing to the soldier rarely occurred to people. When it did, it was mainly the "atrocities" -- killing civilians or prisoners in gory ways -- that got the attention, not the ordinary killing of traditional combat.

More recently, some research has been done on this. From U.S. government data on its Vietnam veterans, those who say they killed have more severe PTSD than those who say they did not. It was not just that they were in more intense battle, because those who killed in light combat had heavier PTSD scores than those who did not kill even though in heavy combat. The form of PTSD shows those who say they killed had much more by way of intrusive imagery -- nightmares, flashbacks, unwanted thoughts that just will not go away -- and also much more by way of irritable outbursts. They also tended to have higher scores on measures of alienation, hypervigilance, and feelings of disintegration. But those who had not killed were more likely to have the pattern of concentration and memory problems. (For the statistical analysis MacNair conducted of the National Vietnam Veterans Readjustment Study, see pp. 174-181 of her book).

As Dan Baum documents in the article cited above, the VA has also been reluctant to address the issue of the trauma of killing directly, thus impeding the treatment of veterans. He interviewed Dan Knox, a Vietnam veteran, who told him:

In order to properly treat combat veterans, Knox said, the V.A. would have to change its mission. “They’d have to change from the ‘me’ to the ‘I.’ Not just ‘What happened to me?’ but ‘What did I do?’ But they can’t go there.” The V.A., Knox said, “is not there for the veteran. They’re there as a palliative for the non-veteran. To make people feel good, like they’re doing something for the vet.” Knox occasionally speaks to high-school students about war, but he is rarely invited back. The message he tries to leave behind is: “Killing people sucks.”
Hundreds of Thousands of Veterans Are at Risk

In "Returning Home from Iraq and Afghanistan: Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families" the Institute of Medicine, under contract from the Department of Defense, attempted to conduct an overview of the needs of veterans returning from Iraq and Afghanistan. They report:

A recent RAND report (Tanielian and Jaycox, 2008) estimated that some combination of comorbid PTSD, major depression, and TBI is not uncommon in OEF and OIF veterans. The report noted that about one-third of service members who have been deployed have at least one of the three conditions, and about 5% manifest symptoms of all three (Tanielian and Jaycox, 2008). Furthermore, of 289,328 OEF and OIF veterans seen at VA health care facilities following deployment, 106,726 (36.9%) received mental health diagnoses and of those receiving any such diagnosis, 29% had two and 33% had 3 or more different mental health conditions (Seal et al., 2009). Of those veterans, 62,929 (21.8%) were diagnosed with PTSD and 50,432 (17.4%) with depression. (page 64)
Furthermore:
In a RAND study of OEF and OIF veterans, 18.5% reported depression or PTSD (Tanielian and Jaycox, 2008), slightly higher than the prevalence found in its review of 22 other studies, which showed that 5––15% of veterans experienced PTSD symptoms when deployed to war zones. The study also suggested that prevalence of PTSD symptoms increases with time after deployment (the readjustment period) (Tanielian and Jaycox, 2008). (page 68)

and:

Repeated deployments themselves have also contributed to mental health issues. About 27% of those who have been deployed three or four times have received diagnoses of depression, anxiety, or acute stress compared with 12% of those deployed once (MHAT-V, 2008).  (page 29)
According to the report, over 1.9 million soldiers have been deployed to Iraq and Afghanistan since 2001. Even if we utilize the (very) low-end estimate reported above that 10% of these soldiers are suffering or will suffer from Post-Traumatic Stress, it is reasonable to expect that over 190,000 veterans of these wars will suffer from PTSD as a result of their war experiences, and it is quite possible that the real number of sufferers will be twice as high. As reported above, almost as many will suffer from depression and endure other mental health problems.

Yet despite the distinguished panel who worked on this official report for the Institute of Medicine, the word "kill" does not appear in the report, except to note that asking for mental health services is known in the services as a "stripe killer," i.e. a barrier to promotion.

I don't know how many of the 1.9 million soldiers deployed killed or believe they killed anyone (no one does, partially because the military doesn't ask in its psychological questionnaires upon leaving the military). But the real psychological needs of these soldiers and veterans are rendered invisible by reports such as the one above from the IOM, and from the LA Times story on drone operators.

Of course, when discussing these kinds of numbers, the pain of each and every veteran can get lost, so I'm including below a video for a song by a veteran who goes by the name of Washed Up Soulja. This is his "PTSD Song," and it speaks eloquently to the powerful role of guilt as he struggles to survive post-traumatic stress. Warning: this song describes suicidal ideation. If you or anyone you know is considering harming yourself, please get assistance and call the National Suicide Prevention Lifeline, 800-273-8255, and if you're a veteran, push 1, or text 838255. (According to the IOM study quoted above, "Veterans were twice as likely to die of suicide as nonveterans in the general population (Kaplan et al., 2007)." (page 70).

http://youtu.be/...

Veterans for Peace and Iraq Veterans Against the War are two organizations seeking to address these traumas. VFP organizes Healing the Wounds of War projects, for example, through which veterans help rebuild civilian lives in Vietnam and Iraq. IVAW co-sponsors the War is Trauma art project, has initiated Operation Recovery, a campaign to stop the re-deployment of soldiers already suffering from trauma, and has a list of additional resources for veterans.

When young people are being recruited, military recruiters straining to meet their quotas rarely talk with young people about the realities of war, including the danger of psychological harm arising from experiences in the military. In fact, as I've written about elsewhere, too many recruiters actually lie, including telling recruits that they won't get deployed. It is up to all of us to counter the falsely glamorized picture of military life and war too many young people still receive.

Originally posted to samdiener on Tue Apr 03, 2012 at 02:07 PM PDT.

Also republished by In Support of Labor and Unions and Community Spotlight.

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Comment Preferences

  •  Might I recommend "On Killing" (11+ / 0-)

    http://en.wikipedia.org/...

    An excellent book on the subject by a former Ranger.  I won't go into my own experience with the subject, since it's unpleasant to revisit, but I will say the book helps quite a bit.  (Although I admittedly disagree with some of his conclusions)

    I don't blame Christians. I blame Stupid. Which sadly is a much more popular religion these days.

    by detroitmechworks on Tue Apr 03, 2012 at 04:39:15 PM PDT

  •  I don't trust the LA Times (7+ / 0-)

    I cancelled my suscription when they laid off  Robert Scheer and they replaced him with Jonah Goldberg.

    http://www.bradblog.com/...

    Killing is stressful unless you are a sociopath.  Specially if you know many of your victims are completely innocent and when you find out that many targets are simply designated by people who have the ears of "intelligence" operatives on a quota.

    Daily Kos an oasis of truth. Truth that leads to action.

    by Shockwave on Tue Apr 03, 2012 at 05:09:24 PM PDT

    •  Good writers remain at LA Times (1+ / 0-)
      Recommended by:
      Ginny in CO

      like Zucchino, for example, and others.

      The problem is the constant slicing and dicing that's gone on at newspapers all over this land over the last decade resulting in the layoff of more than ten thousand reporters, editors, cartoonists, and photographers. It is a massacre exacerbated by the mergers and acquisitions.

      And it is partly the result of people not being willing to pay for online news. With the loss of advertising, there are very few ways for news agencies to make money.

      The result is that the Fourth Estate has been greatly weakened. That's really bad for democracy.

       

  •  I've often wondered about this (11+ / 0-)

    if killing far from the site of the deaths would affect those doing it as it does those who are present where the killing has taken place.

    I write "wondered" because this is the first mention of it that I've come across. My thoughts have always been that sooner or later it would catch up with those who perform the killing even though it is far from the "battlefield".

    Thanks for the diary and discussion of this topic.

    “Humankind can not bear very much reality.” - T.S. Eliot

    by truong son traveler on Tue Apr 03, 2012 at 05:42:25 PM PDT

    •  I've heard about it several times, but (6+ / 0-)

      that may be because I live fairly near one of the bases housing the remote pilots & it might have been local news. NPR also covered it last year (very likely the same Air Force study, but hard to tell).

      They watch someone's pattern of life, see people with their families, and then they can be ordered to shoot.
      ...
      "When they have to kill someone," he says, "or where they are involved in missions and then they either kill them or watch them killed, it does cause them to rethink aspects of their life."

      [Col. Kent] McDonald describes it as an "existential crisis."

      NPR story

      This stress is in addition to their helplessness at not being able to protect their own colleagues on the ground.

    •  It does (12+ / 0-)

      and it even trickles down, in diluted form, to those of us who never directly kill anyone at all.

      When you go into the Navy as an aircraft mechanic...hell, when you join the enlisted Navy in almost any capacity other than master-at-arms...you go in knowing that you'll almost certainly never be called to kill someone. You'll never be issued a weapon in the line of duty. You'll never even be allowed to carry a weapon on any military facility, and as long as you're deployed or live on base, the only time you'll ever put your hands on a gun is at the shooting range. And even that is optional outside of a 2-hour training course in boot camp. You'll have less access to and less contact with deadly weapons than your average civilian.

      So the Navy in general, and its maintenance field in particular, doesn't attract the sorts of people who think they might be OK with killing people. In fact, it tends to attract people who specifically do not want to kill anyone. People who are attracted to the military for one reason or another (structured environment, demanding/rewarding job, college money, job training, getting the hell out of some small town) but are not remotely interested in taking lives, who have an instinctive aversion to killing that in some cases matures into a full-force philosophical objection.

      And we're not trained to kill. We're not even given the basic defense-mechanisms prerequisite to killing - we're not taught to dehumanize, to objectify, to turn off our empathy. In fact, we're encouraged to value life. The life-saving aspect of our jobs is constantly emphasized. And we're taught to be culturally-competent in countries we visit, to treat non-Americans with respect, to empathize, to value human life and dignity. That's a core part of Navy training.

      And yet we're enabling people to kill. We're saving lives by doing our jobs well...but those lives we save go on to take other lives. And that's a serious conflict. It's a constant topic of conversation. It requires constant rationalization. "I never killed anyone." "I saved pilots' lives." You rationalize, you deny, but it's always in the back of your mind: some people in Iraq and Afghanistan are dead because of me. Because the plane that I fixed went on to fly another day. Because the pilot whose training I supported went on to drop bombs in the Middle East.

      "Let’s just move on, treat everybody with firmness, fairness, dignity, compassion and respect. Let’s be Marines." - Sgt. Maj Michael Barrett on DADT repeal

      by kyril on Tue Apr 03, 2012 at 10:05:58 PM PDT

      [ Parent ]

      •  Thanks for this, Kyril (2+ / 0-)
        Recommended by:
        kyril, Carol in San Antonio

        I think this is an eloquent statement of some of the intellectual/moral origins of Navy conscientious objectors such as Dan Fahey.

        We regularly do receive calls to the GI Rights Hotline, 877-447-4487, from all the branches of the military, including Navy personnel who are considering applying for conscientious objector status because they can no longer, for reasons of conscience, participate in the war system.

        I remember counseling one potential Navy CO who fell in love with the ocean via surfing and started questioning the military system when he witnessed its horrific environmental impact.

    •  I think that's the purpose of technology (0+ / 0-)

      To make killing more distance, more remote, not simply easier and more efficient.

      "A cynical, mercenary, demagogic press will produce in time a people as base as itself." - Joseph Pulitzer

      by CFAmick on Wed Apr 04, 2012 at 08:56:20 AM PDT

      [ Parent ]

  •  A topic which should be explored more often. (10+ / 0-)

    The most powerful question ever asked me was how would I feel about having to kill someone just like me, but on another side.  Since, I have seen that the question also involves killing someone whose side is not even certain.

  •  T&R (9+ / 0-)

    Its even worse when you realized it was done because of a lie.

    BOHICA
    RA18960500
    Repentant ex member of Murder Inc.
    Southeast Asia Division

    "White-collar conservatives flashing down the street. Pointing their plastic finger at me."

    by BOHICA on Tue Apr 03, 2012 at 07:43:10 PM PDT

    •  I admire your (0+ / 0-)

      honesty, and my guess is your anguish at having been lied into the military and at having been coerced into military operations is immense.

      I think some veterans don't want to critically examine government policies about war and peace because it appears psychologically easier to justify participating in war if one can pretend it is for a "good cause." The moral courage I've seen  exhibited by members of Veterans for Peace and Iraq Veterans Against the War, who face directly the moral implications of their actions, and just as importantly the moral responsibility of political, economic, and military leaders who initiated these wars, and often seek to communicate their pain to current high school students to help them avoid making the same choices, always staggers me.

      Are you in touch with other anti-war veterans via organizations such as Veterans for Peace?

      I'm also curious about the graphic on your sig. I couldn't help noticing the Playboy bunny on the graphic indicting the Army Air Corps' role in Vietnam. Is it there because you're critiquing the misogynist version of violent exploitative masculinity that was and is being inculcated by both the military and Playboy?

      •  I am a member of VFP (2+ / 0-)
        Recommended by:
        native, Just Bob

        The Playboy bunny was on the transmission tower of our Cobras because we were the 1st Platoon, call sign "Playboys", of my company (334th AHC,  145TH Combat Aviation Battalion, First Aviation Brigade).

        My ship


        Unit patch


        My present uniform

        "White-collar conservatives flashing down the street. Pointing their plastic finger at me."

        by BOHICA on Wed Apr 04, 2012 at 09:19:03 AM PDT

        [ Parent ]

  •  This is damned important shit... (9+ / 0-)

    Take it for gospel from an Air Force Vietnam vet.

  •  Print article vs online? (1+ / 0-)
    Recommended by:
    native

    I don't have access to LAT print edition of this article. Assume you refer to material online that did not appear in print? That's how you knew something was cut? What was cut?  Read your diary several times -- did I miss it? If not can you please blockquote that cut material and put it here in an update or in a comment so we know what you're talking about specifically? Just curious.

    Did Stars and Stripes pick up the (cut) print version? I can't get thru your link to S&S as it goes into Facebook with a phishing warning. I went direct to S&S site but too late at night to do a tedious line by line comparison of S&S with online LAT story to see what's missing. Most of the comments are indeed dismissive.

    Totally agree the whole remote-killing drone subject is a vitally important question for multiple reasons not least this PTSD dimension. Just starting Rachel Maddow's new book "Drift" which I expect will deal with drones as an exemplar of "the unmooring of American military power."
    _________
    Don't let Rush get away with it! Build your own FCC Complaint

    •  Sorry this Wasn't Clear (1+ / 0-)
      Recommended by:
      Just Bob

      I haven't seen the material that was cut from David Zucchino's story. I emailed him to complain that he omitted from the article any discussion of the psychological impact of killing.

      He wrote back to tell me that, as I quoted in the diary, "My original story did indeed have a short section on the effects of killing, but it was edited out for space. So it goes in the ever-shrinking world of original journalism." The online version is, as far as I know, identical to the print version. The Stars and Stripes version is identical, as far as I know, to the LA Times version.

      When I wrote to Zucchino I said

      I know that some publications are putting more extensive information on their web sites - particularly when key parts of a story are edited out for the print version. Given the (understandable) reactions to your piece, I wonder if your editors might approve a side-bar on this issue on your website.
      He didn't respond to this part of my email.
  •  It's just not natural for us to kill our species (4+ / 0-)

    Except for the psychopaths who are broken.

    The rest of us just are not made that way, we have an aversion to killing that eats away at us if we think we did something that led to the deaths of others.

    Geez, we feel guilty at hurting others emotionally, much less physically. It's built into our genes as social animals. We need to feel like we did good, and knowing we helped to kill, or did kill, does not foster that feeling.

    Please sign the White House petition to Flush Rush from AFN (Armed Forces Network).

    by splashy on Wed Apr 04, 2012 at 01:54:56 AM PDT

    •  I guess Cheney and Wolfowitz and Kissinger and (2+ / 0-)
      Recommended by:
      samdiener, native

      all those must be psychopaths, then? And all the cops who don the militarized combat gear and bust heads and knees in all those orchestrated assaults on "freedom" that the Occupiers dared to try to exercise? Or bar bullies and road ragers and Catholic groper priests etcetera? How about all those billions of hours' worth of time spent by "ordinary people" who say "it doesn't affect me, I'm not violent" "playing" at "Call of Duty" and "Doom" back in the day?

      I don't know, it seems to me that "we" are pretty good at hurting and killing each other. Naturally. For "the best of reasons," or just for the fun of it.

      "Is that all there is?" Peggy Lee.

      by jm214 on Wed Apr 04, 2012 at 05:22:04 AM PDT

      [ Parent ]

      •  I Think All Human Behavior is Natural (6+ / 0-)

        "I am human, I consider nothing human alien to me." - Terence, sometimes called the first writer of the African Diaspora, in his comedy, The Self Tormentor, from 163 BCE

        As Solzhenitsyn said,

        “If only it were all so simple! If only there were evil people somewhere insidiously committing evil deeds, and it were necessary only to separate them from the rest of us and destroy them. But the line dividing good and evil cuts through the heart of every human being. And who is willing to destroy a piece of his own heart?”
        -- The Gulag Archipelago
        Humans are animals, and I can't remember where I first read someone making this analogy because it was about three decades ago, but both our technological marvels and our technological nightmares (including nuclear weapons, as immoral as I consider them to be) are just as "natural" as a beaver dam.

        I agree with you, Splashy, that harming others causes us psychological harm. I also agree with JM214 that violence in human history is both ubiquitous and natural. I believe both violence and nonviolence are quite naturally part of our potential range of behavior as humans. I think it's pretty clear that we have evolved capacities to inflict grotesque brutality on each other (see the history of slavery, torture, and war in societies (though not in every society) across the globe). And we have evolved the capacities for transcendent agapic love (See MLK's Loving Your Enemies).

        For more on the evolution of cooperation, by the way, please see Martin Nowak's "The Arithmetics of Mutual Help" (pdf) (and his new book Supercooperators), the book Nonzero: the Logic of Human Destiny, by Robert Wright (despite the grandiosity of the title and the pretzels he ties himself into in a bizarre attempt to justify war, for example, it's a spectacular book on biologic and cultural evolution through the lens of how win-win relationships can evolve), and for a scholarly review article, "Sixteen common misconceptions about the evolution of cooperation in humans," by Stuart A. West, Claire El Mouden, and Andy Gardner(pdf).

      •  We have eyes on the front of our (0+ / 0-)

        heads, and we see in color, for a specific reason.

        "A cynical, mercenary, demagogic press will produce in time a people as base as itself." - Joseph Pulitzer

        by CFAmick on Wed Apr 04, 2012 at 08:59:02 AM PDT

        [ Parent ]

        •  Okay, I'll bite (0+ / 0-)

          What do you think is the reason? If two eyes are good, wouldn't more eyes have been better (able to see danger and opportunity in more directions at once), like a dragonfly? Of course, natural selection doesn't necessarily work that way, no humans might have been born with those mutations, or they might have been, but had other problems that didn't add to survival, or who knows what random event occurred wiping out that line even if it did start to successfully evolve.

          •  Predators, carnivores, have eyes (0+ / 0-)

            on the front of their head to better focus on their prey. We see in color to differentiate our prey from the background.

            "A cynical, mercenary, demagogic press will produce in time a people as base as itself." - Joseph Pulitzer

            by CFAmick on Wed Apr 04, 2012 at 09:08:48 AM PDT

            [ Parent ]

            •  true about binocular, less so about color vision (1+ / 0-)
              Recommended by:
              Just Bob

              Our long-range vision and especially our perception threshold for movement just plain suck compared to most other predators.

              There's a competing argument that humans' binocular color vision suggests origins as fruit-eating tree-dwelling monkeys, who would have (and do today) benefit from good depth perception and the ability to distinguish a wide range of colors.  Wooded environments also have short lines of sight, which make being comparatively near-sighted less of a disadvantage.  Like most predators, monkeys have a clear need for a solid grip, but unlike most predators, they also need fine motor control to manipulate fruit.

              There's no question that our eyes have aided our predatory lifestyles, but we also owe a lot of our success there to our ability to sweat and jog our prey to exhaustion: we're slow and weak as hell.

              Never attribute to stupidity what can be adequately explained by malice; stupid people couldn't hurt us so effectively.

              by Visceral on Wed Apr 04, 2012 at 03:57:03 PM PDT

              [ Parent ]

              •  Dont confuse (0+ / 0-)

                modern man with access to limitless food with he human animal.

                You may think you lack good long range vision and movement perception but that is because you dont need those skills.  Placed in a situation where you need all of your senses, your body, and more importantly your mind, adjusts.

                In the field, I can smell a cigarette from a mile away.  Same with cooking food or soap.  A 1/4 moon is all I need to move at night.  I can spot a moving vehicle 15 miles away and tell you what direction it is moving.  I can hear a stick break from 500m.  Slow and weak?  I can move 20 miles in 8 hours with 40lbs on my back and still have the ability to put 38 of 40 in a small circle 150+ meters away.

                Your animal instincts are inside you.  

                It is well that war is so terrible -- lest we should grow too fond of it. Robert E. Lee

                by ksuwildkat on Wed Apr 04, 2012 at 07:37:42 PM PDT

                [ Parent ]

    •  It is not natural (3+ / 0-)
      Recommended by:
      betson08, allenjo, Ginny in CO

      for most people.

      However, military training and indoctrination along with the dehumanization of the enemy makes it possible to overcome, at least temporarily, our own natural instincts.

       

      “Humankind can not bear very much reality.” - T.S. Eliot

      by truong son traveler on Wed Apr 04, 2012 at 08:44:33 AM PDT

      [ Parent ]

  •  Thanks for a great piece (8+ / 0-)

    and an important reminder.  In my work with combat veterans (20+ years) and as a PTSD/Trauma studies researchers, I've been arguing for decades the basic truth that killing people is bad for you.  Not as bad, of course, as being killed, and there are certain psychopaths who thrive on killing, but the average person pays a high price for killing, even in a war s/he considers "just," and even enemies s/he considers "evil."  The pain of those soldiers who kill in the service of an unjust war, or who commit murder or atrocities in wartime is intense, especially if you watch measures like suicide rates, self-medication through drugs, and other mental health statistics.

    Working with Vietnam combat vets, it's always the infantry -- the folks on the ground -- who grab attention.  But after several years I began to see the devastation wrought by killing on men who had never seen their victims face-to-face: pilots who flew bombers, men on big ships who had manned the big guns, even guys who remained Stateside but were acutely aware that their work had contributed to the deaths of many.  The deepest pain I saw was in a man who had worked in the Inspector General's office in Saigon, who never heard a shot fired in anger, but who had unwillingly participated in the cover-up of the failure of the M-16, and of a particular Huey helicopter part -- both of which were responsible for the death of many, many U.S. GIs -- at the level of an office clerk.  

    And of course the military doesn't want to talk about this.  Rank-and-file soldiers are throw-away people, and always have been in the U.S.  (The plight of today's veterans is not so different from those who marched in the Bonus Army and slept in the Hoovervilles in the 1930s.)  The bottom line, though, is that we ask the men and women who fight our wars not only to risk their lives, but to sacrifice their psychological well-being.  And it doesn't even matter if it's a "good war." Few people know that when the Veterans Readjustment Centers were finally approved in 1979, they were flooded with World War II and Korean War vets.

    The answer is not more and better therapy for PTSD (though of course we want that, too).  The answer is.... PEACE.

    "If you fake the funk, your nose will grow." -- Bootsy Collins

    by hepshiba on Wed Apr 04, 2012 at 02:50:07 AM PDT

    •  Totally Agree With You - And a Question (4+ / 0-)

      "The answer is not more and better therapy for PTSD (though of course we want that, too).  The answer is.... PEACE."

      I'm grateful to you for doing this work for so long, Hepshiba. Because or your expertise in this field, I'd like to ask you about another interest of mine: the connection between combat stress and battering/domestic violence. When I looked into it a few years ago, the VA was not denying the linkage, but was not even trying to prevent domestic violence in its PTSD programs, because, they claimed, there was no reputable study documenting the effectiveness of such prevention programs with those suffering from combat stress. I wonder if you have experiences and/or could refer me to references/resources along these lines.

      •  The VA does have a study (5+ / 0-)

        underway and it does have some prevention programs in place.  Here's a link to an ongoing study.  In a Feature Article on the DVA site, they note:

         

        The good news is that there are VA programs aimed at addressing the health effects of IPV and reducing IPV risk. For example, the VA is researching and developing several IPV intervention programs, including a couples-based therapy program. The VA is also researching and developing better ways to ask about IPV in primary care settings.

        There are many types of talk therapies, which may help those who have experienced IPV deal with PTSD, depression, and anxiety. Some of these therapies, such as cognitive processing therapy, are available to Veterans through the VA and at Vet Centers. They are there to help men and women with safety planning and locating services.

        Blue Shield has a number of links to family violence prevention for veterans. There are some good readings on Gambill on Justice. You may want to take a look at the relatively new volume by Macdermid called Risk and Resilience in U.S. Military Families because it has a chapter that deals specifically with PTSD and interpersonal violence. The CDC is funding a project called Veterans, Trauma, and Battering Behavior  If you don't have access to a university library I can help you get copies of recent papers.

        But… you're looking at the intersection of several problems here.  The first is that the military & the VA both have a vested interest in playing down violence perpetrated by veterans, or on the partners of vets. The second is a history of dismissing any kind of violence against women.  Brushing these under the rug is an ingrained habit.  The third is that the military and the VA have been running public relations damage control around the issue of PTSD since the antiwar veterans movement pushed hard enough to get the diagnosis into DSM III.  The military is now heavily invested (and this is more and more true with each passing year) in either pharmaceutical or mechanical "solutions" to the problem caused by endless war: an unending flow of mentally damaged veterans reintroduced to civilian life.  

        The military's main concern:  how to keep soldiers from breaking down in combat, so that you can keep sending them out to kill people.  The VA's main concern:  how to provide as little treatment as possible to the men and women who served their country, for as little money as possible.  The government's main concern:  how to keep the growing number of military vets as unobtrusive and as disempowered as possible so they don't cause any trouble, or serve as an example that would sway the population against future wars.

        Domestic violence takes place at the intersection between PTSD (which the military wants to pretend it can cure or prevent) and violence against (mainly) women (which the military doesn't give a shit about).  It happens mostly in the domestic sphere (so it doesn't scare the government into action) and it requires preventive programs (which cost money and challenge patriarchal business-as-usual).  There's not going to be a pill for it, so it doesn't attract pharmaceutical research money, and it doesn't make better soldiers, so there isn't military research money. In short, it's really low on the VA list of action items.

        Clearly IPV is a problem for many vets with PTSD (and there are a lot of studies to back up that claim), but there's no indication that existing models of domestic violence prevention will not work for combat veterans.  My suggestion would be to get veterans to speak directly with organizations that provide prevention and treatment programs for intimate partner violence and see if groups can be set up especially for vets, led, perhaps, by both a veteran's counselor and a DV counselor.

        The bottom line is that if anything is going to get done, it's going to have to be veterans who do it, and one of the most successful collaborations of the 1960s and early 1970s was between combat veterans and feminists.  When the vets set up their rap groups, they were modeled on women's consciousness raising groups. The idea of breaking out of gender roles that many vets saw were literally killing them was very attractive.  And many women saw the pain of veterans as a reflection of the pain they had experienced.  There's a high proportion of PTSD in both groups.  These are groups that have already proven they can work together, and at the moment, I believe that they (we!) really need each other.  

        "If you fake the funk, your nose will grow." -- Bootsy Collins

        by hepshiba on Wed Apr 04, 2012 at 02:22:46 PM PDT

        [ Parent ]

    •  tools (1+ / 0-)
      Recommended by:
      Ginny in CO

      As a commander it was my responsibility to give my soldiers the tools to allow them to deal with the dark side of the Profession of Arms.

      I commanded an intelligence unit and after September 11th much of the unit was involved in high value targets (HVTs).  The job my soldiers did was to say "this is a bad man and he needs to die."  Their assessment was often the final the justification for a 2000lb bomb being dropped on someones head.  Sometimes it was easy - the person would be open about who they were.  Sometimes it was hard and they would say "Im 60% sure."  Well that means 40% unsure.  We ran out of easy targets fast and more and more were in the 60/40 range.  I saw this starting to take a toll - was I really 60% sure?  What if I was wrong?  And some times they were and knew it because they would find the person later, very much alive.  Not a good day.

      In response I began a series of classes on just war theory.  By chance one of the post Chaplains had done his PhD on the subject.  We talked though the works/teachings of Thomas Aquinas and other just war thinkers.  But I also worked a parallel effort to dehuminize the people we were killing (I will not go ingot detail so dont ask).  I know that sounds evil, but my concern was the mental health of my soldiers.  

      Fast forward to 2004/2005 - a funny thing happened when Iraq turned into a living hell - deciding who was bad and who wasnt didnt seem so stressful any more.  Compared to being blown up in an IED or having you head blown off by a sniper, sitting behind a computer and figuring out bad guy locations was good living.  There seems to be an element of "relative evil" that impacts combat stress.  Having seen the worst, just sucky didnt seem so bad.

      Iraq presented some very very very difficult issues for all of us teaching just war concepts.  I was forced to concentrate on defending others from unjust acts and was lucky that AQI and the Shia militias supplied ample unjust acts. If you cannot make your war just, make someone else more unjust.

      Thank you for your work with vets.

      It is well that war is so terrible -- lest we should grow too fond of it. Robert E. Lee

      by ksuwildkat on Wed Apr 04, 2012 at 07:20:40 PM PDT

      [ Parent ]

      •  This is like a long drink after (3+ / 0-)
        Recommended by:
        hepshiba, samdiener, ksuwildkat

        decades in a desert. 35 years in nursing, with many vets from many wars, has reinforced this over and over.

        It is amazing how much we have known about this aspect - and denied it.

        I have added it to my reasons for doing away with the death penalty. Over a decade ago there was supposed to have been a study on the Texas 'Tie Down' team. I suspect the money was diverted or the results destroyed.

        Cops, people who kill in self defense, and those who place the IVs and strap down death row inmates for execution have reported depression, flashbacks, etc.

        Thank you all so much. Vets especially need to be willing to talk about this. In a recent comment thread regarding Zimmerman's mental state, I brought this up and cited the military training and vet problems. Had a response from a vet who was upset about vets being portrayed as I had. He had served in the support areas and would not have experienced most of it. (Also much shorter tour, probably not repeated) He also relayed being active in vet support groups and not hearing anything about this.

        I have hopes that before we start wars for water, we can get enough of this information out to help the vets who need it, and keep from sending more into combat.

        "People, even more than things, have to be restored, renewed, revived, reclaimed and redeemed; never throw out anyone. " Audrey Hepburn "A Beautiful Woman"

        by Ginny in CO on Wed Apr 04, 2012 at 11:14:16 PM PDT

        [ Parent ]

      •  On dehumanization. (2+ / 0-)
        Recommended by:
        samdiener, ksuwildkat

        Dehumanizing the enemy is a central pillar of the philosophy behind preparing American soldiers for combat (and not only American soldiers, but that's the population I work with).  It's also one of the chief contributors to a climate that fosters and supports the commission of atrocities during wartime. Dehumanization is a blunt instrument:  it does not apply simply to enemy combatants, but to an entire enemy population, including civilians.  Nor does it stop at war's gate: it carries over into a soldier's personal life when s/he returns home.

        You and I could probably debate just war theories until the cows come home, and I don't doubt it would be a fascinating discussion.  But the point I want to underline here is that dehumanization is effective for getting and keeping soldiers combat-ready in the short term: it works well when you're cheerleading soldiers in a "Go Team!" effort to win a battle.  In the long term, though, dehumanization degrades rather than supports the mental health of soldiers and veterans, and it has a negative impact on a soldier's relationships when s/he reintegrates into civilian life.  I can go into more detail on how this works, if you're interested.

        One of the things I've learned working with Vietnam veteran writers (mainly poets) for a generation, is that when you dehumanize the enemy for an 18-20 year-old kid, and he commits acts that he couldn't have committed if he saw the enemy as human, you wind up with a ticking time-bomb of a man whose devastation is immeasurable, years later, when he, one day, looks his own child in the eye and sees clearly the reflection of the humanity of those he has killed.  The poet W.D. Ehrhart sums this up beautifully, as do others poets like John Balaban, Dave Connolly, Horace Coleman, Dale Ritterbusch, Yusef Komunyakaa, and Leroy Quintana.  At best, dehumanization is a stop-gap measure, and at worst, it's a gateway drug to atrocity, depression, and despair.

        And I say this as a woman who has loved many veterans as brothers, and who can forgive the young man who committed atrocities, as long as he grows into an older man committed to peace.

        Killing wounds soldiers, and there is no way to truly protect them from that wound, except by stopping wars.

        "If you fake the funk, your nose will grow." -- Bootsy Collins

        by hepshiba on Thu Apr 05, 2012 at 04:25:11 AM PDT

        [ Parent ]

  •  Why is PTSD so much more prevalent (0+ / 0-)

    among American vets than British? It's like ten times less. I've been wondering that for a while now.

    •  Got a cite to support that? My bet is that Brits (1+ / 0-)
      Recommended by:
      betson08

      are culturally better at submerging their emotions and hiding distress. Does not equal "less" of it. And since I bet more of the public there is aware of the futility of effectuating the cynical bullshit that passes for "military intervention to protect national security and promote national interests," my guess is that the internal tensions and dissonance might actually be worse.

      http://healingptsdtrauma.com/...

      "Is that all there is?" Peggy Lee.

      by jm214 on Wed Apr 04, 2012 at 05:28:14 AM PDT

      [ Parent ]

    •  I think it's in your citation (2+ / 0-)
      Recommended by:
      peggy, Just Bob
      Among the possible reasons for the discrepancy are use of reserve forces and differences in dwell time.

      The study found British reservists were more likely to deal with post-traumatic stress. If the same were true of the Americans, it contribute to the higher rate since reservists make up 30 percent of U.S. forces but only 10 percent of British forces.

      Also, British troops serve six-month tours, and no more than 12 months in every 36. Depending on the service, American troops might serve more than 12 months at a time with only a year between deployments.

      Helping a food pantry on the Cheyenne River Reservation,Okiciyap." >www.okiciyap.yolasite.com<"

      by betson08 on Wed Apr 04, 2012 at 11:54:00 AM PDT

      [ Parent ]

      •  Do the Brits redeploy disturbed troopers on meds? (2+ / 0-)
        Recommended by:
        betson08, Ginny in CO

        The US practice of sending soldiers who are in psychological trouble back to the front lines with only a bottle of pills for support is very bad. I think, but am not sure, that the guy who recently murdered those Afghans was one of those patch up and ship out cases. If he wasn't, I have read of many other soldiers who committed suicide and were a victim of that type of treatment.

        Conservation is green energy

        by peggy on Wed Apr 04, 2012 at 03:48:40 PM PDT

        [ Parent ]

      •  Time on task (3+ / 0-)
        Recommended by:
        Just Bob, betson08, Ginny in CO

        Length of deployments is a HUGE factor.

        I learned the hard way that my limit is 18 months.  My doc doesnt want me going more than 15 months just to be safe.  I found that out by going for almost 22 months.  When we reconstructed things, I started getting loony at 18 months.  I have since done 14 months without incident.

        It is well that war is so terrible -- lest we should grow too fond of it. Robert E. Lee

        by ksuwildkat on Wed Apr 04, 2012 at 06:35:20 PM PDT

        [ Parent ]

    •  Read "THis Kind of War" (1+ / 0-)
      Recommended by:
      Just Bob

      by T.R. Fehrenbach.  He describes how various POWs broke down during the Korean War.  Short version - Americans did the worst because they allowed their discipline to collapse.  

      Extending the argument - British society is far more structured and rigid than American society.  In combat we use various tools to shift moral responsibility for killing to others.  As an example, fire commands are used to shift the responsibility from the trigger puller to the person ordering you to shoot.  The person giving the order in turn shifts moral responsibility either higher or to the person pulling the trigger.  The regimentation of the British Army and society allows more of that moral transfer.  American society is more individualistic and less of the moral responsibility gets shifted.  

      Combat stress is water in a glass.  Some of us have bigger glasses than others but we all get full at some point.  We can pour some out if we have the right tools but some always stays behind and eventually reaches the top.

      It is well that war is so terrible -- lest we should grow too fond of it. Robert E. Lee

      by ksuwildkat on Wed Apr 04, 2012 at 06:30:39 PM PDT

      [ Parent ]

  •  Clint Eastwood dealt with this (0+ / 0-)

    The movie "Gran Torino" is a must see if you haven't as yet.

  •  OMFG Really? (0+ / 0-)

    I sooooo dont want to hear about PTSD from guys who press buttons while watching video and then GO HOME to their families.  

    You want stress?  Try driving IED infested roads EVERY DAY.

    The AF has been trying to foist this crap on us for a long time and even had the nerve to put UAV guys in for Combat Awards.  Good god they cant even decide to press the launch button - they have to ask permission.

    Get real.

    It is well that war is so terrible -- lest we should grow too fond of it. Robert E. Lee

    by ksuwildkat on Wed Apr 04, 2012 at 06:22:20 PM PDT

  •  Thanks for intoducing this important subject. (2+ / 0-)
    Recommended by:
    Just Bob, Ginny in CO

    A contributing factor to America's tolerance of, and often enthusiasm for war, is the fact that most Americans have absolutely no idea what war actually is. As a public, we are largely shielded from the murderous nature of it. Combat veterans of course, are not. There is a huge disconnect.

    "Here's another nice mess you've gotten me into." - Oliver Hardy

    by native on Wed Apr 04, 2012 at 06:56:04 PM PDT

  •  Maybe one of these decades (2+ / 0-)
    Recommended by:
    Just Bob, Ginny in CO

    they'll actually figure out that just witnessing violence can cause PTSD.  In the real world, this is known.

    "Let me issue and control a nation's money and I care not who writes the laws." Mayer Amschel Rothschild, 1790

    by FreeTradeIsYourEpitaph on Wed Apr 04, 2012 at 06:58:57 PM PDT

  •  Thanks to all (0+ / 0-)

    Great comments.

    Others have simply gotten old. I prefer to think I've been tempered by time.

    by Just Bob on Wed Apr 04, 2012 at 07:53:01 PM PDT

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