More thoughts on battle trauma: how there are different forms

Though I am not involved in the treatment of battle trauma (and, therefore, no expert – remember that these are my impressions as a result of my personal inquiry over the years), it seems that there are different forms of this problem.  We tend to say that there is ‘battle trauma’ but, in my opinion, this is misleading.  This is because ‘battle trauma’ is actually made up of different types of problems, many of which are totally different from each other.  As a result, they cannot all be considered the “same illness”.  In many ways, their only common point is that they originate from stresses and conflicts achieved in the battle situation.  There are many situations, reactions, and causes of trauma in battle.  This is further complicated by the way in which a person reacts to the varied events in battle as well as a person’s character.  They all add up to create a large variety of forms of battle trauma.

THE TWO FORMS OF BATTLE TRAUMA

I tend to see that there are two forms of battle trauma: 

  1. Those caused during battle.
  2. Those caused on reflection. 

Here are some examples of battle trauma that are caused during battle:

  • Battle panic.  This is a terror or panic that originates from the confrontation of battle.  It can happen at the first confrontation of battle or it can happen every time there is a battle.  For some people this can create a paralyzing terror toward battle in general.  The fact that this exists can predispose a person to future problems, particularly if it is repetitive.  On the other hand, the overcoming of battle panic can also mean a person has a great ability to handle the stresses of battle. 
  • Shell shock.  This is a repetitive event of something that is horrifying to the person.  It can include things such as the sound of shells (for which it gets its name), which has a ‘horror of war’ quality associated with it.  Every time they hear it a horror is created in one’s mind – the horror of the death it can cause.  As a result it can make a person “cringe” every time they hear it.  Hearing it repetitively then becomes, in a sense, a ‘continual reminder’.  Because of this, they are repetitively frightened of the idea of what could happen.  This could drive some guys to ‘go out of their minds’ or loose a sense of reality. 
  • The horror of battle – observing itJust seeing the horrors of battle can leave a lasting impression on people.  Seeing death, dismembered bodies, and such, can be an image that continually comes up in your mind, years after you see it.  This is particularly bad when you are somehow emotionally connected with the event, such as seeing a friend killed.  When this happens it seems that the event ‘kills a part of us but leaves us alive’.  That is to say, there is a tendency to ‘feel as we have died too’ when we have strong emotional connections to the event.   
  • The horror of battle – doing it.  Having to perform the horrors of battle can create trauma in a person.  The act of seeing what one does, and the horror one inflicts, can leave a lasting impression on a person.  Interestingly, this does not seem to be as traumatic as you’d think it would be.  It seems to me that this often becomes traumatic when one reflects on what one has done later, not when a person is in the act of doing it.
  • Exhaustion.  Being continuously put in the exhausting and traumatic situation of battle can wear a person down.  Battle, by its nature, forces a person to be ‘awake’ and ‘aware’ which means that a lot of their self is used to deal with the battle.  This exhaustion can have a long-lasting effect on a person, wearing their person and self down.  Not only that, it can wear a person down so much that their defenses will drop, predisposing themselves to an increased or exaggerated battle trauma. 

Here are some example of battle trauma caused on reflection (that is, not during battle but after):

  • The horror of battle – doing it.  Often, doing the horror of battle is not as traumatic as it seems.  That is to say, inflicting horror doesn’t give the trauma necessarily.  What gives the trauma is on reflection, when one realizes what one has done.  This is often done, interestingly, in a situation where nothing is happening, such as resting or laying in bed at night.   This is a good example of how the event does not need to be happening to become traumatic.  It seems that, in general, some of the worst battle trauma is done by a person’s mind, on reflection, than at any other time.   
  • The moral issues.  After observing, doing, and reflecting on ones events, a person may have moral misgivings about what is happening.  This can be devastating to their ability to handle battle trauma.  If one disagrees with what one is doing then you cannot expect them to be ‘at their best’.  But I’m sure that many soldiers with this dilemma would not mention it (perhaps even to themselves . . . ) as it would go against national pride and the ‘team’.  Doing this, though, only weakens them to battle trauma.
  • One’s general attitude.  A person’s attitude, really, is the basis for a lot of battle trauma.  Part of military training is to try to instil good and healthy attitudes for the field of battle.  Often, though, what seems to work in training does not work that well out in the field.  In general, a person’s attitude will often determine if they get battle trauma and what form of battle trauma they will have.  Most of a person’s attitude originates, though, from hereditary, ones childhood, ones society, and growth.  These are uncontrollable and often unknowable things, often entailing qualities and traits a person doesn’t even know about themselves.  This makes a person’s attitude a very mysterious force and element.  It creates quite a dilemma with battle trauma as this mysterious ‘thing’ is the basis of how they will react to battle.  Not knowing this makes it so that, really, the only way for someone to know if one will have battle trauma is to be in battle.  This, to me, shows that despite what it may appear, some people are just prone to battle trauma . . . for whatever reason . . . and there’s really no way of knowing beforehand, nor is there anything you can do about it.  That’s the way it is!

Often, battle trauma, it seems to me, is made up of a number of different types of trauma put together in something like a mixture.  This ‘mixture’ would depend on the person, their character, and the situation they were under.  In some cases, though, it could only be one form but I would think that a battle trauma ‘mixture’ is more the norm, particularly if they have been in battle for long periods of time.

In general, it seems that the ‘war in the mind’ is worse than the war itself.  What I mean by this is that the memories, emotions, and such is where the trauma usually lies.  In short, its how the war rests in a person’s mind that matters. 

In some respects, the real trauma of war does not happen in the midst of battle but in the years following ‘out of battle’, as it sits and festers in one’s mind.  There the ‘reality’ becomes more apparent, of what really happened, and the mind can fully ‘digest’ what happened.  This is not surprising.  Often, the ‘act’ of war does not do much trauma.  This seems to be because the mind is ‘too busy’ to notice what’s going on while ‘in action’.  The mind is just too focused, concentrated, and absorbed to ‘digest’ what it’s doing properly.  This happens after the battle.  As a result, the period of time after battle can be critical in the development of war trauma, for it is here, in a way, that it begins.

Because the mind plays such a big part in battle trauma I sometimes tend to think that ‘cranial’ people, who are educated and ‘think a lot’ (such as in the U.S.) tend to succumb more easily to battle trauma than people that aren’t ‘cranial’.  In effect, this would mean that education makes people more susceptible to battle trauma.

SOME PREDISPOSITIONS TO BATTLE TRAUMA

It seems that there are a number of qualities that can mak a person more prone to battle trauma.  I should point out that many of these qualities are never discovered until battle is confronted.  These include things like:

  1. Being unprepared.  In reality, most people are not prepared for it, regardless of their training or what they ‘think’ they can do.
  2. Fantasy images of war . . . and discovering the truth.  Many males tend to think that there is a ‘glory’ in war.  This motivates many of us to want to enlist or at least be fascinated by war.  I, myself, was brought up with this fascination (which continues to this day).  The problem is that this is not the reality.  My inquiry over the years has shown that war, really, is nothing but a horrific traumatic experience, especially modern-day warfare.  If one looks in the past wars you will find repetitive examples of guys enlisting, thinking its glorious, only to be horrified by the reality.  This means that many guys are going into battle with erroneous opinions of what it is.  Discovering the truth can be devastating for some people.
  3. Being able to hand battle as a continuous life-threatening event.  The continual stress and horror of war can ‘add up’, so to speak.  Some people can handle a ‘few events’ very well, but when there are many events it can wear their defenses down.
  4. A persons general attitude.  As I said above a person’s attitude has many elements and origins. 
  5. A persons motive for going in.  Often, the motive for enlisting, though it sounds good, tends to fall apart when the stress begins.  I know, from observation, that many guys join for a number of ‘wavering reasons’ such as:  they think it will make them tough, to cater to high views of themselves, because of an “interest” in the military, for various ‘high causes’ (patriotism, etc.), and so on.  Though these sound good, and even honorable, they often don’t have the integrity to hold together under stress.  It’s for this reason that I tend to feel that the motive that makes a person enlist should be looked at very seriously and critically.
  6. Problems with a continual sense of helplessness.  In many cases, battle is nothing but a continual sense of helplessness.  This fact can be very damaging to some guys, particularly if they have big ‘egos’ that don’t allow for this emotion. 
  7. Difficulty having ones life threatened.   Battle is nothing but a threat to ones life.  Many people don’t react well when their life is threatened.  Since a life threatening situation is so ‘serious’ many people will react in unexpected ways, often in a way they never thought they would. 
  8. Military attitudes.  I tend to feel that a lot of military attitudes often do more damage than not.  Though they may mean well, teaching guys they are ‘tough’ or part of an ‘elite team’ often locks guys into a way of being that they cannot get out of . . . they have to portray that image.  Oftentimes, this does not reflect who they are.  It also makes them try to be someone they are not.  I tend to believe that the stresses of battle require a person to be ‘genuine’, nowadays, and not ‘artificially created’ at a boot camp.  This may have been true in generations past but I do not believe it is true with the current generations.
  9. Too much education.  As I discussed above, too much education may make a person more susceptible to battle trauma.

THOUGHTS ON THE TREATMENT OF BATTLE TRAUMA

It seems to me that each form of battle trauma requires different treatment techniques, depending on the nature of the problem and the person.  One cannot have just a ‘one treatment’ for battle trauma, in general.  This is because they are not all the same.  Not only that, a person having different forms of battle trauma can require the need for different forms of treatment, each specific for the different forms of battle trauma.

Because we’re dealing with life threatening situations (which are usually repetitive in battle) the complexes of battle trauma are often very deep and may hit a person ‘to the core’.  This gives it a unique and ‘serious’ quality.  A persons reaction to such conditions can be very severe and involved.  As a result, any treatment can very easily take years and they still may not fully overcome it in their lifetime. 

The problems of battle trauma are a result of things that appear in the experience of battle.  These reactions are often unforeseeable and difficult to predict.  Guys that may be ‘gung ho’ may find they change after they see the ‘reality’.  Often, guys must continue to serve regardless of their reaction (if they admit it or not).  But the conditions of enlistment do not allow for a guy to leave the military because its ‘too traumatic’ (at least as far as I know).  As a result, it seems that a lot of battle trauma is a result of guys who have experienced battle trauma and not being able to get out when they really should.  This puts many guys in a situation of ‘having to endure’.  I would think that this is a serious issue as all its going to do is predispose them to even more battle trauma.  It seems that if a guys begins to feel battle trauma it would be wise if he gets out of that situation . . . but they can’t . . . or wont’.

Not only that, we must remember that to ‘want to get out’ makes one look incompetent, a traitor, a weakling, a coward, and so on to the other soldiers.  This is a horrible thing in the ‘military world’.  As a result, many guys will do nothing.  Because of this fact it shows that peer pressure is a significant element in the creation of battle trauma.

ONE OF THE EFFECTS OF THE ‘REALITY OF WAR’ – THE CREATION OF A ‘NEW SELF’

Often, battle trauma is manifested by a tendency to not want to be out of battle or the war situation.  They continually want to go back in, even though it is traumatic to them.  I have always thought this is because of the ‘reality’ of war and how it creates a ‘new self’. 

For some people the ‘horror’ and impact of war is so great that it, in effect, destroys all other ‘realities’ in life.  It becomes the ‘only reality’, that which makes everything pale in comparison.  In so doing, it creates something like a ‘new self’ reflecting this ‘new reality’.  Despite the horror and trauma of this ‘new self’, the ‘war reality’ is so powerful that it becomes ‘life’, so to speak, their only way of being.  As a result, they want to as if grow in this ‘new self’, almost as if to ‘live out this new self as a growth process’.  It makes them want to stay there in battle, regardless of the stresses it causes, and the problems they receive.  For some people, it seems, this can be addicting. 

Not only that, this ‘new self’ can make it extremely difficult to adjust to everyday life again.  The ‘war reality’ brought on the ‘new self’ with a whamm!  Normal everyday life doesn’t do much of anything.  It doesn’t offer a ‘new self’ or much of a reality to compare with the ‘war reality’.  As a result, there is nothing to change their ‘new self’ to the ‘normal everyday self’.  This creates quite a dilemma for many people.  Often, all that can happen is that they must live in normal everyday life and slowly, over a long period of time, let the ‘new self’, which was created by the ‘war reality’, slowly waste away.  It becomes something like a ‘curing by attrition’ in a way.

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