Combat Stress

With the deployment of US military troops to areas of conflict across the globe, effective ways to deal with combat stress has become a high priority. Combat stress casualties are not a new problem, but the way combat stress is dealt with has changed profoundly in the last century.

Shell shock, as combat stress used to be called during World War I, was often viewed as a coward’s reaction to fighting. There were little or no selection procedures to filter out the emotionally vulnerable or those with psychiatric illnesses. Men were killed by firing squad that today would never have be admitted into the military. The few men who were diagnosed with combat fatigue were evacuated home often when it was too late for recovery. Many developed chronic psychiatric conditions.

Changes in military selection

World War II changed a few things.

In the US there was more pre-recruitment screening. The problem of combat stress was grudgingly accepted as part of warfare and by the end of the conflict every division had uniformed psychiatrists. Another major change was men were no longer moved away from the front to receive treatment, except for logistical reasons, or in severe cases. In Korea there was even a mobile psychiatric unit conducting “stress control operations” near the front.

Male culture, the military and emotion in warfare

Male culture still had difficulty dealing with man’s emotional response to war. Vietnam underlined this. Despite progress, there remined little acknowledgement of combat stress. Many men turned to drugs such as marijuana, heroin, morphine, amphetamines, LSD and alcohol. The lack of engagement with such a central issue cost many men their lives both on the battle field, in conflict zones and with post traumatic disorders after the war finished.

Recent conflicts show that things have moved on. This can be attributed to a more informed and a better educated society. Multi media access to information and news is greater than ever before. We continue, quite rightly, to wrestle with the dilemma about what price we are prepared to pay to ensure the defence of nations.