On a very superficial level, there’s not much to explain about Post Traumatic Stress Disorder (PTSD) among serving and former military personnel: we send people off to war, they experience things that no human being ought to, and they bear the mental scars as a result.
However, once you delve deeper into the phenomenon – as Sebastian Junger does in an important and challenging essay for Vanity Fair – the truth is immensely more complicated.
At no point does Junger dismiss what PTSD sufferers go through (not least because he’s gone through it himself), but he does show that the relationship between the condition and actual experience of combat is far from straightforward:
“Many soldiers go through horrific experiences but fare better than others who experienced danger only briefly, or not at all. Unmanned-drone pilots, for instance—who watch their missiles kill human beings by remote camera—have been calculated as having the same PTSD rates as pilots who fly actual combat missions in war zones, according to a 2013 analysis published in the Medical Surveillance Monthly Report.”
This isn’t limited to pilots:
“…even among regular infantry, danger and psychological breakdown during combat are not necessarily connected. During the 1973 Yom Kippur War… rear-base troops in the Israeli military had psychological breakdowns at three times the rate of elite frontline troops, relative to their casualties. And during the air campaign of the first Gulf War, more than 80 percent of psychiatric casualties in the U.S. Army’s VII Corps came from support units that took almost no incoming fire, according to a 1992 study on Army stress casualties.”
It might seem absurd to talk about war becoming ‘safer’, but from a western point of view, casualty rates have never been lower – and yet, as Junger points out, “the American military now has the highest PTSD rate in its history”:
“…decade after decade and war after war, American combat deaths have dropped steadily while trauma and disability claims have continued to rise. They are in an almost inverse relationship with each other.”
Junger argues that some of what is reported as PTSD resulting from combat experience actually stems from the alienating experience of returning to mainstream society:
“Clinically speaking, such alienation is not the same thing as PTSD, but both seem to result from military service abroad, so it’s understandable that vets and even clinicians are prone to conflating them. Either way, it makes one wonder exactly what it is about modern society that is so mortally dispiriting to come home to.”
Junger goes on to describe the extreme contrast between the intensely communal life of serving in a tightly bonded military unit and the radically disconnected society that awaits our soldiers back home:
“A modern soldier returning from combat goes from the kind of close-knit situation that humans evolved for into a society where most people work outside the home, children are educated by strangers, families are isolated from wider communities, personal gain almost completely eclipses collective good, and people sleep alone or with a partner.”
Family provides some support, but “it is not the same as belonging to a large, self-sufficient group that shares and experiences almost everything collectively.” We sometimes refer to the role of ‘extended families’ in non-western societies, but perhaps we should pay closer attention to the ‘truncated families’ in our own society – if, that is, they’re not broken altogether.
There’s no denying that our ever more individualised society affords us considerable freedom and opportunity. However, when we choose to live in a way that is so disconnected from the lives that soldiers must live, we need to think a lot harder before sending them to war.