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More evidence of the MH "blind spot" on PTSD

A story in today's USA Today reveals that "1 in 4 Iraq vets ailing on return." As always, the Pentagon spokesperson and mental-health leaders attributed the mental health problems only to what happened to Soldiers, giving no attention to what Soldiers may have done.

“The (wartime) deployments do take a toll,” says Lt. Col. Ellen Krenke, a Pentagon spokeswoman. “We send them to austere locations, places that are extremely hot, extremely cold, very wet, very dry … where they may also encounter an armed enemy.”
As if feelings of suicide after a deployment were caused by the weather in Iraq.

The article also included this list from DoD:
Of servicemembers returning from the Iraq war this year:
  • 47% saw someone wounded or killed, or saw a dead body.
  • 14% had an experience that left them easily startled.
  • 6% wanted help for stress, emotional, alcohol or family problems.
  • 2% had thoughts of hurting someone or losing control.
  • 1% had thoughts that they might be better off dead or could hurt themselves.
Given that we know--anecdotally, from research, and from common sense--that killing another human being is usually a traumatic experience, shouldn't we be talking about the experience of killing and how we can help Soldiers prepare for it and come to terms with it? This "blind spot," this unwillingness to speak about an aspect of our profession that makes many of us uncomfortable, is harming our Soldiers.


Silvia said…
Congratulations on your blog. I saw the link on the website and was pleasantly surprised to see such a rich discussion on ethics, which I think most people don't imagine exists in the US military.
I only see one problem about your argumentation on the right to take another person's life: I think most would agree that if a robber breaks into your house and points a gun at you or someone in your family, killing him would be self defense. But if the robber who broke into your house and found you armed somehow managed to kill you first, could that be called self defense?
I guess what I mean is that it is easier to understand the right to kill in wars when countries are defending themselves from an enemy, when they have been invaded or directly attacked by that enemy. But when a country is occupied, to me it seems that the people in that country who resist are exercising their right to self defense - like the person who had their house invaded - and the soldiers who have invaded, in this case, would be the robbers.
I'm not American and I'm against the war on Iraq - I guess that´s clear in this post - but I don't mean to be offensive at all either. I respect everyone's opinion and the soldiers who fight in Iraq, because I know most of them must believe that they are doing the right thing. I'm just presenting this question because exactly because I liked the explanations you gave on various topics in your posts and I would like to know your opinion.
Once again, please don't take any of this as an offense.
Pete said…
As the examples in the discussion of the alleged moral equality of soldiers make clear, intentions and actions of all parties involved do matter.

To respond directly to your questions:
1. If a robber comes into my house and I get my gun and confront him, he is NOT morally justified to kill me in self defense. He has already forfeited his right to not be killed (by threatening the rights of me and my family). I could kill him in self defense, but he would be morally wrong if he were to kill me.

2. The analogy to Iraq expands this idea. IF the insurgents had been peaceful Iraqis before the war (i.e., had not forfeited their rights by killing this own people), then they could fight US and Coalition forces in self defense. But, in reality, today's insurgents were yesterday's Baath thugs and Fedayeen. They were killing their fellow Iraqis and didn't need any excuse about an "occupation." Even today, they intentionally kill many more Iraqis than they do Americans.

Going back to the robber case, we have to keep in mind that the armed robber is there to do harm. The US in Iraq is spilling its blood and treasure to help the Iraqis form a society that is just.

A useful analogy would be police and social services going to a home where deranged parents are torturing and killing those entrusted to their case, their own children. Just as parents do not have absolute rights within their houses to violate the rights of their children, governments do not have absolute rights to terrorize their citizens. Thus, just as it would be morally permissible (obligatory?) for police and social servives to intervene, so was it for the US to do so in Iraq, IMO.

Thank you for the question.
One Veteran said…
I am an OIF II vet, and I think that you are right in suggesting that soldiers suffering from PTSD are often just as disturbed by what they have done as by what was done to them.

I am not sure there is any way to prepare someone to kill another without remorse, and I am not sure you would want to create a killer like that, even if it were possible.

The best way to cope with PTSD and other combat related mental health issues is a rigorous post-deployment screening. From personal experience, my screening consisted of a few questions asked by a seemingly disinterested medical officer who had about two hundred soldiers to see after me. Another case of the army 'checking the block', going through the motions without really getting past the surface of a problem.
My two cents.
RJO said…
(This is a very interesting weblog. I hope you'll continue to maintain it over time.)

With respect to (for lack of better terminology)) "passive" vs. "active" experiences and PTSD, my intuition is also that the active experiences are more likely to be disturbing that passive (environmental) experiences. But running counter to that intuition are the data Jonathan Shay reports in Achilles in Vietnam: exposure to material deprivation had the second-highest correlation with PTSD, second only to exposure to abusive violence. Not sure what to make of that.

Regarding the reluctance you detect in MH reporting--reluctance to focus on the "active" causes of traumatic stress--I would suspect there is an unwillingness to be excessively frank in the non-military media about what soldiers are called on to do in combat situations. The non-military public may just not want to hear about that, so it is easier to talk about environmental deprivations. If this attitude actually has negative consequences *internally* then it would indeed be a cause for special concern.
Anonymous said…
Wanted to add to this. I am a current vet of 3 Iraq tours and 2 Afghanistan tours. Been in multiple IED strikes, countless raids, dismount patrols, mounted patrols and overwatch of a number of towns to get intel. And through out all of this I have had soldiers next to me get hurt and killed and I know its ny duty to push on and do my job. It fires me up when Soldiers, Airman, Marines, and Sailors come home saying they have PTSD. When that's your job to suck it up and hide what bothers you. Only 1% of re U.S. has the balls to do what the u.s. military does. That's why we are what we are. If I can gut it out after what I have seen and done. Then you can to. If not get out and go li e with mom and dad cause it will never change unless we change what goes on over there!