Post Traumatic Stress Disorder, PTSD, is a serious problem for America and its war veterans – and that does not bode well for a society that supports war and militarism as a means to generate capital. The high prevalence of civilian assault, rape, child abuse, disaster, and violent incidents also makes PTSD a public health problem -- as borne out by the 1995 national study that estimates at least five percent of men and ten percent of women experience PTSD at some point in their lives; and roughly thirty percent develop a chronic form that persists for life.
War trauma is not new: “soldier’s heart” was the term used to describe it during the American Civil War; “shell shock” during World War I; “battle fatigue” or “war neurosis” during World War II; and “Post Traumatic Stress Syndrome” during Vietnam. Then a “syndrome” (“a group of signs and symptoms that collectively characterize or indicate a particular disease or abnormal condition”) evolved into a “disorder,” that is, an “illness.” Post Traumatic Stress Disorder formally entered the Diagnostic and Statistical Manual of Mental Disorders (DSM III) in 1980.
DSM IV describes PTSD as a psychological condition experienced by people who face traumatic events that cause “catastrophic stressors outside the range of usual human experience” (such as war, torture, rape, or natural disaster). This is different from “ordinary stressors” (such as divorce, failure, rejection, and financial problems) characterized as Adjustment Disorders.
Embraced by scientific and clinical communities (if not wholehearted by the U.S. military), PTSD today is among the panoply of acceptable modern ailments for which treatment exists.
Whether they seek treatment or not American military personnel and their families have access to mental health services. Yes, it may be difficult within the “suck-it-up” military culture to admit the need for psychological care; yes, it may be difficult to receive high quality, ongoing care from an overburden VA; and, yes, perhaps military mental health care relies too heavily on prescription medications…but systematic care is available.
But PTSD is not confined to America. It is prevalent in countries experiencing natural disasters and the social upheaval war brings: loss of home, family, and cultural identity; constant threat of sudden and extreme violence; and impoverishment, scarcity, and displacement. UNHCR 2011's refugee statistics indicate almost 44 million people worldwide are forcibly displaced.
An insidious legacy develops for families in countries too war-torn to offer systematic mental health treatment: PTSD is handed down to future generations.
Iraqi psychiatrist Dr. Ali Hameed explains, “Parents who are victims of war trauma themselves are often incapable of addressing their children’s trauma since no one addressed their trauma.”
Iraq. Before the 2003 invasion, Dr. Ali Hameed researched PTSD in children at the University of Baghdad. He found it difficult to measure Iraqi children’s psychological health since Iraq has experienced decades of conflict: the Iran-Iraq war, Gulf War I, a dozen years of U.N. sanctions followed by the invasion and almost a dozen years of violent occupation, and millions of internally and externally displaced people.
“While Americans and adult Iraqis were jubilant at Saddam’s demise, children witnessed a mythical figure disappear, someone who loomed larger than life, for whom songs were sung and holidays celebrated. They saw statues topple, mass graves exhumed, families huddled in bombed-out buildings, and mothers and fathers humiliated by terrifying invaders. No child should witness such events.”
Palestine/Occupied Territories. East Jerusalem’s Palestinian Counseling Center works with Palestinian families whose symptoms of acute and chronic trauma include withdrawal, academic regression, aggression, affect dysregulation, hopelessness, helplessness, mania, depression, and suicide.
Former counselor Rashid says, “It has to do with seeing people wounded on the streets, violence at military checkpoints and during curfews, tear gassing, overcrowded living conditions, and growing up in refugee camps. With Israel’s increasing use of high-tech weaponry and home demolitions we see increasing incidences of selective mutism among children. Not surprising since a home is not just a collection of bricks stuck together but a place of safety and security that a child relates to: my books, my toys, my birth certificate, my pictures, and so on.”
Unrelenting shock stuns children into silence; unrelenting violence and deprivation may keep them there.
Lebanon. Mrs. Fadiah Jobeily is principal of a girls school in Sidon with programs geared to socialize children of different backgrounds.
“We want our country to be united and what we do at school is a reflection of what we want in the greater society around us.”
Yet a constant state of warfare or anticipated warfare destroys infrastructure and “also destroys personalities.”
“Girls are not growing normally; they’re more aggressive and unable to see a future worth struggling for. Why study when another war will start?”
Teachers once engaged in civic and school activities are depressed and withdrawn too.
“They tell me, ‘I feel everything is bad.’ This is a recurring theme throughout the country. People are losing the will to live. Or they flee their homeland for safer places. We fight against the disastrous sense that even as we fix things another war can begin any time and destroy our lives again. This has been our situation for the last 25 years.”
Afghanistan. Rahima Haya promotes literacy and cultural understanding in the U.S.
“Today Afghanistan has close to two million widows – 70,000 in Kabul alone -- many of whom are illiterate and mothers to five or more children. It’s shocking to see children and women -- young, old, beautiful – all begging on the streets.”
With three million refugees, one out of three of the world total, Afghanistan continues to be the prime country with the most refugees under UNHCR. Growing up in refugee camps inflicts privations; the seeds for ultra-conservative, black-and-white thinking of the Taliban, for example, began in refugee camps.
The financial cost of war is appallingly high but it is relatively easy to tally. It is not easy to tally the complex cost of evolving psychological traumas generating every minute around our distressed world.
Perhaps PTSD diagnoses will become more nuanced and, in the future, another DSM term and theory will be published. But what harvest will we reap tomorrow from seeds of unresolved trauma sown in today’s increasingly deadly wars on increasingly fragile human beings? And, can our world afford it?
