Did Roman troops suffer from PTSD?

Did Roman troops suffer from PTSD?

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After the wars in Afghanistan and Iraq there has been a lot of talking about how many soldiers suffer from PTSD when they return home.

I'm interested in knowing more about war trauma and PTSD in ancient warfare. It would perhaps be useful to narrow it down to the lets say the Roman era.

I imagine that wars back then can be considered more "brutal" than what we have today, most of the fighting happening in very close combat with many dead and dismembered bodies laying around (as opposed to the relatively small engagements modern armies are use to today and of course the fighting parties tend to keep greater distances between themselves nowadays). My initial guess would be that soldiers surviving these engagements would suffer from terrible trauma.

On the other hand, these people would have led more "brutal" lives than we have today. I imagine they would have been exposed to violence at younger ages (crucifixion of criminals, arguments ending up with swords, animal and possibly human sacrifices, more instances of death around them etc… ). Additionally I imagine their culture and religions probably prepared them for this level of violence. Compare that with the childhood and the life the average (Christian, religion that doesn't really prepare for war and violence) westerner lives before seeing war for the first time.

I'm particularly interested in knowing if any ancient writers left any records talking about war trauma in soldiers of their time?

PTSD, or stress reactions from battle, were well known during the Greek and Roman era. The Greeks understood it very well. Alexander the Great's men are said to have mutinied after suffering "battle fatigue."

These examples of Roman era PTSD are taken from a blog of ancient examples sourced from Max Hastings', An Oxford Book of Military Anecdotes:

According to Herodotus, in 480 B.C., at the Battle of Thermopylae, where King Leonidas and 300 Spartans took on Xerxes I and 100,000-150,000 Persian troops, two of the Spartan soldiers, Aristodemos and another named Eurytos, reported that they were suffering from an “acute inflammation of the eyes,”… Labeled tresantes, meaning “trembler,”…

During the Roman siege of Syracuse in 211 B.C., a number of Greek soldiers defending the city were “stricken dumb with terror,” according to Greek historian Plutarch. Surdomutism, which is now recognized as a common conversion reaction to the stress of combat, was first clinically diagnosed during the Russo-Japanese War of 1905.

According to Peter Connolly, the Greek military historian Polybius wrote that as early as 168 B.C., the Roman army was quite familiar with soldiers who deliberately injured themselves in order to avoid combat.

According to The VVA Veteran, a Congressional Organization:

Aristodemos (example above) later hung himself in shame.

It relates the story of another Spartan commander who was forced to dismiss several of his troops in the Battle of Thermopylae Pass in 480 B.C.

"They had no heart for the fight and were unwilling to take their share of the danger.”


The Greek historian Herodotus, in writing of the battle of Marathon in 490 B.C., cites an Athenian warrior who went permanently blind when the soldier standing next to him was killed, although the blinded soldier “was wounded in no part of his body.” So, too, blindness, deafness, and paralysis, among other conditions, are common forms of “conversion reactions” experienced and well-documented among soldiers today

During Romans battles with Hannibal of Carthage, the battle of Cannae was the worst. 50 thousand Romans were encircled & killed in a matter of hours, when the dust settled and soldiers were able to burn the dead, they found Roman soldiers in the middle who had literally dropped and tried to smother themselves & escape the carnage by buring their heads in the earth. Apparently war has always brought men to terrifying and dark places. I can't imagine watching that level of carnage unfold in front of you and be remotely notmal again.

What does the Bible say about PTSD?

The Bible does not say anything specifically about Posttraumatic Stress Disorder, or PTSD. However, we can glean much guidance from some indirect teachings in the Bible.

Posttraumatic Stress Disorder develops in some people following a traumatic event. The event, or “stressor,” could be exposure to death or threatened death, actual or threatened serious injury, or actual or threatened sexual violence. The sufferer may be directly exposed, indirectly exposed through a family member or close friend experiencing the event, or extremely or repeatedly indirectly exposed through his or her work (such as first responders, police officers, military personnel, or social workers). Common trauma experiences are combat, car accidents, natural disasters, abuse, rape, and mass violence. (It should be noted that combat PTSD is a bit different than other forms of PTSD this will be discussed in more detail below.) After such an event, most people will show signs of stress such as feeling on edge, anxiety, fear, anger, feelings of depression, a sense of detachment, desire to avoid trauma-related reminders, flashbacks, difficulty sleeping, headaches, changes in appetite, irritability, self-blame, “survivor’s guilt,” or a sense of numbness. For most people, these reactions lessen and eventually subside with time.

Those who develop PTSD have persistent symptoms for more than one month. Other symptoms for PTSD sufferers include intrusive re-experience of the trauma such as through recurrent, involuntary memories, nightmares, or dissociation avoidance of trauma-related thoughts or feelings or external reminders negative changes in thoughts or behavior, including an inability to recall details related to the trauma, persistent negative beliefs about oneself or the world, loss of interest, feelings of alienation, or inability to express positive emotions and changes in arousal or reactivity such as irritability, aggression, hypervigilance, reckless behavior, or sleep disturbances. In PTSD sufferers, these symptoms cause significant impairment in work or social functioning. The United States’ National Center for PTSD estimates there are 5.2 million adults suffering from the disorder in any given year.

The situations that cause Posttraumatic Stress Disorder are different for different people, and not everyone responds in similar ways to similar situations. It is unclear why some develop PTSD and others do not. It seems that biological make-up, type of support received following the event, presence of other life stressors, and having effective coping mechanisms may contribute to whether a person develops PTSD. Interestingly, though symptoms of PTSD usually emerge immediately following or within a few months of the traumatic event, that is not always the case. PTSD can develop years later. How long the PTSD lasts also varies&mdashsome suffer for years, whereas others recover in several months.

PTSD resulting from participation in combat seems to be unique from other forms of PTSD. In combat situations military personnel are often both victim and aggressor, a dynamic which adds complexities to the issue. Often those with combat-specific PTSD will exhibit depression, extreme feelings of guilt, hypervigilance, and low self-esteem. It can be particularly difficult for combat veterans to process through the atrocities they have witnessed, come to a place of acceptance over the things they have been tasked to do, and readjust to non-combat living. For Christian military personnel, it can be especially difficult to accept taking the life of another, even as an act of war. Christians know the deep value God places on human life and often feel extremely guilty for taking the life of another, even in what would be considered a justifiable circumstance. Many times Christian combat veterans are more deeply aware of their sinful state than are other Christians. They may feel unworthy of God’s love due to the things military service requires of them. Those who suffer from combat PTSD may find accepting God’s forgiveness to be extremely difficult. They may agonize over decisions they made in the many no-win situations in which they were placed during war. They may also have persistent flashbacks of the gruesome realities of war as well as consistently feel on high-alert from months of living in life-threatening situations.

Regardless of the circumstances, there is hope. First and foremost, that hope comes from God.

The treatment process should involve a combination of physical, mental, and spiritual healing. Many will require professional help. For those with combat-related PTSD, it is likely preferable to receive help from someone experienced in treating combat-specific PTSD. There are multiple therapeutic remedies for PTSD available, ranging from talk therapy (often Cognitive Behavioral Therapy) to cognitive reprocessing to eye movement desensitization and reprocessing (EMDR) and other methods. Medication may also help alleviate symptoms. Certainly, a network of support&mdashcounselors, doctors, family members, pastors, the church community&mdashis important in the recovery process. Of course, the most important support is God, our ultimate Healer and Counselor. David wrote, “From the ends of the earth I call to you, / I call as my heart grows faint / lead me to the rock that is higher than I. / For you have been my refuge, / a strong tower against the foe” (Psalm 61:2&ndash3). It is our responsibility to exercise faith in God, to stay in the Word, to cry out to God in prayer, and to maintain fellowship with other believers. We go to God in our distress and make use of the resources He provides.

Those who suffer from PTSD from any experience should recognize that treatment will take time, and that is okay. Some have compared this to Paul’s "thorn in the flesh" (2 Corinthians 12:7&ndash10). God does offer healing, but in the way and the timing He sees fit. In the meantime, He gives sufficient grace to bear up under hardships. Thorns are painful, and PTSD is certainly a big thorn. But we can continue to go to God and remind ourselves of His faithfulness (Lamentations 3 1 Corinthians 1:4&ndash9).

Truth is a key component to coping with or overcoming PTSD. Reminding oneself that God loves, forgives, and values His people is extremely important. Knowing who God says we are and defining ourselves by His standards rather than by what we have done or what has been done to us is important. We need not identify as either victim or perpetrator. In God, we can identify as beloved child (Romans 8:14&ndash17 Ephesians 1:3&ndash6 1 John 3:1&ndash3), sealed in the Holy Spirit (Ephesians 1:13&ndash14), forgiven (Romans 5 Ephesians 1:7&ndash10 1 John 1:8&ndash9), and redeemed. Losing a close friend or family member is incredibly difficult, and many can feel unworthy of being spared. But those with “survivor’s guilt” can remember the truth of God’s sovereignty and that He has a purpose for everyone’s life. God loved the ones who were casualties of war or another crime or tragedy just as much as He loves the ones who survived. His purpose for each person is unique. Replacing the lie that we are unworthy to have lived with the truth that God has a plan and values our days on earth is key (Ephesians 2:10 5:15&ndash16).

Speaking truth about practical things is also important. Often, those with PTSD will feel endangered when the situation does not warrant it. Reminding oneself that this is not the traumatic event but is a new and safe situation is important. It is also important to speak the truth that PTSD is not an excuse for bad behavior. Likely, PTSD will contribute to some negative thought and behavior patterns. This is understandable, but it should be resisted.

Having a community of support who offers grace and forgiveness and speaks truth in love is incredibly important. And it is vital that the community who supports the sufferer of PTSD is also receiving support. Remaining connected to one’s local church is crucial. Time with God through prayer and reading His Word is important for both the sufferer of PTSD and his or her family. Self-care and doing things that are relaxing and refreshing are also important. PTSD often feels as if it overtakes one’s life. Doing things that are enjoyable and life-giving is just as important as confronting the PTSD head-on.

PTSD is a difficult challenge that will require strong faith in God and willingness to persevere. But God is faithful, and each day we can choose to surrender to God’s love, battle the PTSD as best we can, and ultimately rest in God’s grace and compassion. PTSD is not something to ignore but something to turn over to God and actively engage with. We are invited to approach God boldly and to pour out our hearts to Him (Hebrews 4:14&ndash16). We are assured that nothing can separate us from His love (Romans 8:35&ndash38). God can restore the mental health of the PTSD sufferer. In the end, God can even use the situation for His glory. “Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God. For just as we share abundantly in the sufferings of Christ, so also our comfort abounds through Christ” (2 Corinthians 1:3&ndash5).

Is there evidence of PTSD in ancient warrior cultures?

I was thinking of the Spartans, Romans, and/or the Vikings in particular. Does being raised around violence and a warrior culture affect PTSD development? I'm curious if it's a nature vs nurture issue. Are we as humans prone to feeling bad about war or does being raised in a culture that is based in combat change this?

Iɽ love to hear your thoughts. Thank you.

I can expand slightly on the Roman situation.

Following from Rosemary85's post, there is also Caesar in Vietnam:Did Roman Soldiers Suffer from Post-Traumatic Stress Disorder? which is,unfortunately, paywalled unless you have institutional access.

The thinking in this post is hers. So bear in mind that there will be contrary opinions, this is just one paper. But I find her paper informative and plausible, so I think it is worth sharing.

We tend to assume that that the ancients must have had some form of post-war trauma, but is this justified? We must not forget that the amount of everyday violence experienced by (at least urban dwellers) in the ancient world was considerably more than we experience. The Games spring to mind, where death and bloodshed was common. But of course, trauma may often only result when it is your life on the line. We need to be careful in translating the ancient world to the modern: there is not a one-to-one mapping.

Another problem is limitation or bias of sources: Roman historians weren't interested, generally, in the common soldier (unless they got feisty) - what mattered to them about battles was who was 'right', who won and who lost. Those whom they wrote about were the leaders, generally Senatorial, for whom war was part of being an aristocrat (it changed over time, of course). So evidence is somewhat limited on which to base a diagnosis

There is also this (pg. 217):

A complicating factor in determining whether the Romans experienced PTSD is that the diagnosis and specific triggers of the disorder are not fully understood

What we do know, however, is that PTSD is strongly linked to concussive injuries (pp. 218-9), and these were much rarer in Roman times - exclusively knocks on the head - because the Romans weren't throwing mortars at each other. A link between brain injury and PTSD is suspected - it may not be fully psychological.

The chance to come across the trigger events for PTSD - "witnessing horrific events and/or being in mortal danger and/or the act of killing" (pg 217) was there, so there probably was a baseline level of PTSD, but not the levels we see today because of the comparatively limited number of concussive injuries.

We need also to throw cultural factors in the mix: life was brutal, the position of the military was different, life was closer to death in Rome - the contemporary examples we have of PTSD are in individuals with a much more sheltered life. Romans may have just shrugged it off.

TLDR: we probably will never know whether Romans had PTSD but there are good reasons for thinking that the rate, if any, was significantly lower than in modern times.

CITE: AISLINN MELCHIOR (2011). Caesar in Vietnam: Did Roman Soldiers Suffer from Post­Traumatic Stress Disorder?. Greece & Rome, 58, pp 209-­22

Would have Roman soldiers suffered from ptsd ?

I ask because when I was thinking about this it seems that killing may not have seen as bad or evil in the ancient world as it dose today especially in battle. So would they be more use to killing and not be as negatively affected by it. But would they have suffered from seeing there friends killed in battle or maybe from burning a villages or something along dose lines

I believe this video discusses this question.

I think there lies a certain possibility, yes. You have to keep in mind that the Romans had tens of thousands of soldiers that were at their disposal, willing to lay down their lives for their empire. So to kill another human being probably didn't faze them as much, but I'm sure there were many who did out of loyalty and fear and later realized that fighting for Rome wasn't worth it, nor had the death they caused. This is what I think at least.

Killing may not have seemed as "bad or evil" but that doesn't mean PTSD was lessened because of it. Many of the comments here seem to focus on the difference in culture, however PTSD does not discriminate throughout cultures. It is a disorder caused by traumatic events such as war, which was plenty during the Roman period. If you look at the disorder from a psychological standpoint, it has always existed but wasn't properly diagnosed until the 20th century. There are reports of British and French knights suffering from nightmares, numbness, or flashbacks. I remember reading one account of how the clanking of silverware was enough to trigger an episode, as it reminded the soldier of swords clanging together. I fail to see how the Romans would have been immune from such a disorder, as even the most hardened soldiers can develop PTSD.

The act of killing would actually be a more first-hand experience as a roman soldier. You would often look into the eyes of the enemy as you stab him and feel the friction of iron on flesh through the handle. Wounding would be more frequent, as would unnecesary cruelty. Statistically, dieing takes more time from arrows and spears than from bullets and grenades, so you would hear a lot more screaming from pain and people suffering with little to no medical aid.

The only thing that can make ancient warfare less a cause for ptsd than modern warfare are the bombardment kills and dismemberment. Maybe also airplane diving. In general, shooting a person from afar doesnt yield the same "shock" as killing him with your hands after you lost your weapon or shield would.

So my opinion is that modern warfare ptsd victims have it a little better in terms of shellshock.

Battles would also last for way less time and there were no hidden explosives threatening you. Nor there was constant artillery fire. I’d say modern victims have it a lot worse.

I think you got it all wrong. In Ancient times war was a integral part of the mans life. A good citizen was expected to be a good soldier and if you are thought to be a warrior from little I don't think you'll have too much of a problem with warfare. Also keep in mind that Rome was seen by its contemporarys as a fanatical militaristic society which did not wage "normal" war where you sue for peace after a catastrophic defeat.

Well that’s what I was thinking it was a society where war was something that brought glory and fame not like the world wars where no one really new what to expect

So my opinion is that modern warfare ptsd victims have it a little better in terms of shellshock.

No way dude, at least not when it comes to the shellshock you bring up. That got so bad the people affected by it would sometimes go literally so insane they could no longer even walk properly. Possibly because the constant, incredibly extreme stress they were under eventually damaged their brains.

But the treatment to that was to just rotate the people, so they weren't under this intense stress for weeks or months at a time. The key here being the large amount of time during which the people were stressed out, something that's peculiar to modern warfare during which you may suddenly be killed at any time without warning. In Storm of Steel, Ernst Jünger described a scene where at one moment his company is just sitting around and then the next moment, without any warning, suddenly half of them are dead to a mortar or whatever it was. You can imagine the absurd amount of stress this puts you under, knowing - feeling it, deep within your bones, undeniably that it is as true as that the sun rises in the east - that at any moment you might suddenly die and there's nothing you can do about it. It's incredible people were able to stay sane under those conditions at all.

That's stuff people didn't have to deal with in pre-modern warfare. Theyɽ probably still get traumatized by having to kill people in hand-to-hand combat - phobos being the god of the battlefield, after all - but I imagine that's a very different kind of trauma.

Closest youɽ get to something similar would probably be the manouvering that ancient armies did as a prelude to engagements. They could spend weeks running throughout the terrain trying to get a leg-up on the other in some way or another to induce an engagement in their own favour. I imagine those conditions, especially under the fog of war, could get very stressful, for a very long period of time. Still don't see it being anywhere near as bad as modern warfare though.

There’s some debate about this amongst historians. As I understand it, the theory is that societies that rewarded killing most likely wouldn’t have experienced PTSD as often as modern societies, where there isn’t the same reward system. Of course there are always exceptions, and even Herodotus talks about a guy who went blind in battle, but suffered no obvious injury. I believe there are similar cases mentioned in Roman sources too (Caesar’s writings and others?).

You also have to factor in the way battles were conducted, and the proximity to the enemy. It was much more visceral and brutal than modern warfare, but can you really tell that to a guy sitting in the trenches, day in and day out? Ancient battles were over relatively quickly (unless it was a siege) in comparison to say, battles in The Great War.

We haven’t changed physiologically, but we also don’t fully understand how the brain works and how it can be molded by our environment. But what we do know suggests that if we’re raised a certain way, what might be abhorrent to one person may be normal to another.

My feeling is yes, there were cases of PTSD, but the reward systems in place (and other factors of course) probably negated some of that, relatively speaking.

I think I would rather be a Roman the be in the trenches al fleas when Romans where under fire they could get into tight formations like the tortoise where as in WW1 they where just running in the open

We haven’t changed physiologically, but we also don’t fully understand how the brain works and how it can be molded by our environment.

We may have the same psychological baseline, but we are very different psychologically from the people who lived before us. Our brains do change depending on their environment (sometimes directly observably, as when you teach someone how to read and write), and our psychology along with them.

Take, as an example, one of the more famous experiments into investigating the results of growing up in cultures of honour (http://www.simine.com/240/readings/Cohen_et_al_(2).pdf), where american southerners respond differently to being bumped into and called an "asshole" than northerners do. These are not just people deciding to act differently they will have their reactions long before they've had any time to think about how to react. Their entire bodies will respond differently to the situation one guy's body will have activated (and then repressed) all the triggers for a fight, while the other guy's body won't have.

Why do they respond differently? Because they have a different psychology - different brains and bodies - as a result of having grown up in a different culture.

So I think it's naive in the extreme for historians to talk about people from other times and cultures as if they were the same as us. Yes, in the sense that if they were raised in our society, or we in theirs, weɽ be the same - but we're not the same after having been raised in different societies.

How different would they have been though? Who knows? But we do know it can be quite extreme. For example, humans can teach themselves to enjoy pain, probably the best demonstration of our malleability. The canonical example being spicy food, which humans automatically hate (like they hate all pain), but which they can teach themselves to instead enjoy by literally re-wiring the brain. Of course, there are many other examples. Another healthy one (since spicy food can be healthy) would be learning to enjoy the pain of working out. A less-healthy one might be self-harm.

Or compare people of today, who will burst into tears at the sight of a dog dying in a movie, to people of just a few hundred years ago (and maybe even some people today) who believed that animals couldn't even feel pain. Or compare our modern people to current-day chinese, who quite happily pile body after still-living-body of dogs on top of each other after skinning them alive the confused, suffering animals' whimpering falling on deaf ears. You think you could do that? I couldn't do that. But if I grew up in that society and had different conceptions on animals and their suffering, and about dogs in particular, presumably I would be able to. And if I grew up in a culture that viewed even human suffering very differently from how we do (e.g. it teaches me to totally ignore your suffering if you're not part of my group) I would respond very differently to that as well.

Anyway. Point is, we indeed have changed psychologically, and that could easily extend to being able to endure what we today would call trauma - but which they might view as trivial or even normal, and so they wouldn't get traumatized by it. I would probably get traumatized by watching someone die in front of me. But if you've already seen that a dozen times just growing up? When you've witnessed several mutilations, more fights than you can remember - sometimes to the death - and even seen people get publicly executed to cheers and celebrations? Probably not that traumatizing. Maybe even kinda fun, that brain of yours having rewired itself to enjoy what it otherwise wouldn't: Adapting to its environment.

From shell-shock to PTSD, a century of invisible war trauma

In the wake of World War I, some veterans returned wounded, but not with obvious physical injuries. Instead, their symptoms were similar to those that had previously been associated with hysterical women – most commonly amnesia, or some kind of paralysis or inability to communicate with no clear physical cause.

English physician Charles Myers, who wrote the first paper on “shell-shock” in 1915, theorized that these symptoms actually did stem from a physical injury. He posited that repetitive exposure to concussive blasts caused brain trauma that resulted in this strange grouping of symptoms. But once put to the test, his hypothesis didn’t hold up. There were plenty of veterans who had not been exposed to the concussive blasts of trench warfare, for example, who were still experiencing the symptoms of shell-shock. (And certainly not all veterans who had seen this kind of battle returned with symptoms.)

We now know that what these combat veterans were facing was likely what today we call post-traumatic stress disorder, or PTSD. We are now better able to recognize it, and treatments have certainly advanced, but we still don’t have a full understanding of just what PTSD is.

The medical community and society at large are accustomed to looking for the most simple cause and cure for any given ailment. This results in a system where symptoms are discovered and cataloged and then matched with therapies that will alleviate them. Though this method works in many cases, for the past 100 years, PTSD has been resisting.

We are three scholars in the humanities who have individually studied PTSD – the framework through which people conceptualize it, the ways researchers investigate it, the therapies the medical community devises for it. Through our research, each of us has seen how the medical model alone fails to adequately account for the ever-changing nature of PTSD.

What’s been missing is a cohesive explanation of trauma that allows us to explain the various ways its symptoms have manifested over time and can differ in different people.

Nonphysical repercussions of the Great War

Once it became clear that not everyone who suffered from shell-shock in the wake of WWI had experienced brain injuries, the British Medical Journal provided alternate nonphysical explanations for its prevalence:

A poor morale and a defective training are one of the most important, if not the most important etiological factors: also that shell-shock was a “catching” complaint. – (The British Medical Journal, 1922)

Shell-shock went from being considered a legitimate physical injury to being a sign of weakness, of both the battalion and the soldiers within it. One historian estimates at least 20 percent of men developed shell-shock, though the figures are murky due to physician reluctance at the time to brand veterans with a psychological diagnosis that could affect disability compensation.

Soldiers were archetypically heroic and strong. When they came home unable to speak, walk or remember, with no physical reason for those shortcomings, the only possible explanation was personal weakness. Treatment methods were based on the idea that the soldier who had entered into war as a hero was now behaving as a coward and needed to be snapped out of it.

Electric treatments were prescribed in psychoneurotic cases post-WWI. Photo via Otis Historical Archives National Museum of Health and Medicine

Lewis Yealland, a British clinician, described in his 1918 “Hysterical Disorders of Warfare” the kind of brutal treatment that follows from thinking about shell-shock as a personal failure. After nine months of unsuccessfully treating patient A1, including electric shocks to the neck, cigarettes put out on his tongue and hot plates placed at the back of his throat, Yealland boasted of telling the patient, “You will not leave this room until you are talking as well as you ever did no, not before… you must behave as the hero I expect you to be.”

Yealland then applied an electric shock to the throat so strong that it sent the patient reeling backwards, unhooking the battery from the machine. Undeterred, Yealland strapped the patient down to avoid the battery problem and continued to apply shock for an hour, at which point patient A1 finally whispered “Ah.” After another hour, the patient began to cry and whispered, “I want a drink of water.”

Yealland reported this encounter triumphantly – the breakthrough meant his theory was correct and his method worked. Shell-shock was a disease of manhood rather than an illness that came from witnessing, being subjected to and partaking in incredible violence.

Evolution away from shell-shock

The next wave of the study of trauma came when the Second World War saw another influx of soldiers dealing with similar symptoms.

It was Abram Kardiner, a clinician working in the psychiatric clinic of the United States Veterans’ Bureau, who rethought combat trauma in a much more empathetic light. In his influential book, “The Traumatic Neuroses of War,” Kardiner speculated that these symptoms stemmed from psychological injury, rather than a soldier’s flawed character.

Work from other clinicians after WWII and the Korean War suggested that post-war symptoms could be lasting. Longitudinal studies showed that symptoms could persist anywhere from six to 20 years, if they disappeared at all. These studies returned some legitimacy to the concept of combat trauma that had been stripped away after the First World War.

UNDATED FILE PHOTO – A US Marine on a combat-reconnaissance mission during the Vietnam war crouches down as the Marines moved through low foliage in the Demilitarized Zone Photo via Reuters

Vietnam was another watershed moment for combat-related PTSD because veterans began to advocate for themselves in an unprecedented way. Beginning with a small march in New York in the summer of 1967, veterans themselves began to become activists for their own mental health care. They worked to redefine “post-Vietnam syndrome” not as a sign of weakness, but rather a normal response to the experience of atrocity. Public understanding of war itself had begun to shift, too, as the widely televised accounts of the My Lai massacre brought the horror of war into American living rooms for the first time. The veterans’ campaign helped get PTSD included in the third edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-III), the major American diagnostic resource for psychiatrists and other mental health clinicians.

The authors of the DSM-III deliberately avoided talking about the causes of mental disorders. Their aim was to develop a manual that could simultaneously be used by psychiatrists adhering to radically different theories, including Freudian approaches and what is now known as “biological psychiatry.” These groups of psychiatrists would not agree on how to explain disorders, but they could – and did – come to agree on which patients had similar symptoms. So the DSM-III defined disorders, including PTSD, solely on the basis of clusters of symptoms, an approach that has been retained ever since.

This tendency to agnosticism about the physiology of PTSD is also reflected in contemporary evidence-based approaches to medicine. Modern medicine focuses on using clinical trials to demonstrate that a therapy works, but is skeptical about attempts to link treatment effectiveness to the biology underlying a disease.

Today’s medicalized PTSD

People can develop PTSD for a number of different reasons, not just in combat. Sexual assault, a traumatic loss, a terrible accident – each might lead to PTSD. The U.S. Department of Veterans Affairs estimates about 13.8 percent of the veterans returning from the wars in Iraq and Afghanistan currently have PTSD. For comparison, a male veteran of those wars is four times more likely to develop PTSD than a man in the civilian population is. PTSD is probably at least partially at the root of an even more alarming statistic: Upwards of 22 veterans commit suicide every day.

Therapies for PTSD today tend to be a mixed bag. Practically speaking, when veterans seek PTSD treatment in the VA system, policy requires they be offered either exposure or cognitive therapy. Exposure therapies are based on the idea that the fear response that gives rise to many of the traumatic symptoms can be dampened through repeated exposures to the traumatic event. Cognitive therapies work on developing personal coping methods and slowly changing unhelpful or destructive thought patterns that are contributing to symptoms (for example, the shame one might feel at not successfully completing a mission or saving a comrade). The most common treatment a veteran will likely receive will include psychopharmaceuticals – especially the class of drugs called SSRIs.

Iraq war veteran Troy Yocum walks across the George Washington Bridge from New Jersey to New York accompanied by a Port Authority of New York and New Jersey color guard June 15, 2011.Yokum is hiking over 7,000 miles across America to raise awareness about the severe problems U.S. military families face due to soldiers returning home from overseas deployment with Post Traumatic Stress Disorder (PTSD), and to raise funds to help military families in need. Photo By Mike Segar/Reuters

Mindfulness therapies, based on becoming aware of mental states, thoughts and feelings and accepting them rather than trying to fight them or push them away, are another option. There are also more alternative methods being studied such as eye movement desensitization and reprocessing or EMDR therapy, therapies using controlled doses of MDMA (Ecstasy), virtual reality-graded exposure therapy, hypnosis and creative therapies. The military funds a wealth of research on new technologies to address PTSD these include neurotechnological innovations like transcranial stimulation and neural chips as well as novel drugs.

Several studies have shown that patients improve most when they’ve chosen their own therapy. But even if they narrow their choices to the ones backed by the weight of the National Center for PTSD by using the center’s online Treatment Decision Aid, patients would still find themselves weighing five options, each of which is evidence-based but entails a different psychomedical model of trauma and healing.

This buffet of treatment options lets us set aside our lack of understanding of why people experience trauma and respond to interventions so differently. It also relieves the pressure for psychomedicine to develop a complete model of PTSD. We reframe the problem as a consumer issue instead of a scientific one.

Thus, while WWI was about soldiers and punishing them for their weakness, in the contemporary era, the ideal veteran PTSD patient is a health care consumer who has an obligation to play an active role in figuring out and optimizing his own therapy.

As we stand here with the strange benefit of the hindsight that comes with 100 years of studying combat-related trauma, we must be careful in celebrating our progress. What is still missing is an explanation of why people have different responses to trauma, and why different responses occur in different historical periods. For instance, the paraylsis and amnesia that epitomized WWI shell-shock cases are now so rare that they don’t even appear as symptoms in the DSM entry for PTSD. We still don’t know enough about how soldiers’ own experiences and understandings of PTSD are shaped by the broader social and cultural views of trauma, war and gender. Though we have made incredible strides in the century since World War I, PTSD remains a chameleon, and demands our continued study.

This article was originally published on The Conversation. Read the original story here.

The psychological cost of warfare in the ancient world

Then said Achilles, "Son of Atreus, king of men Agamemnon, see to these matters at some other season, when there is breathing time and when I am calmer. Would you have men eat while the bodies of those whom Hector son of Priam slew are still lying mangled upon the plain? Let the sons of the Achaeans, say I, fight fasting and without food, till we have avenged them afterwards at the going down of the sun let them eat their fill. As for me, Patroclus is lying dead in my tent, all hacked and hewn, with his feet to the door, and his comrades are mourning round him. Therefore I can think of nothing but slaughter and blood and the rattle in the throat of the dying." - Iliad 19.226

As some of you know, I am the spouse of a veteran who has suffered from PTSD since service in Vietnam back in 1967-68. Although the psychological trauma suffered by those who have experienced a traumatic event now has a very modern-sounding diagnosis, it is not a recent phenomenon but has been a plague upon mankind, probably since men began engaging in warfare to wrest the territory or possessions from a competing group or avenge the losses incurred in such actions.

Some scholars have proposed PTSD is a modern phenomenon brought on by the use of explosive weapons like IEDs, land mines, or booby traps and the concussions that resulted from their use.

In her paper, Caesar in Vietnam: Did Roman Soldiers Suffer from Post-Traumatic Stress Disorder?, classicist Aislinn Melchior admits that concussion is not the only risk factor for PTSD but says it is so strongly correlated that it suggests the incidence of PTSD may have risen sharply with the arrival of gunpowder, shells, and plastic explosives.

"In Roman warfare, wounds were most often inflicted by edged weapons. Romans did of course experience head trauma, but the incidence of concussive injuries would have been limited both by the types of weapons they faced and by the use of helmets," Melchior observes. Melchior also speculates that death was so common in the ancient world that it desensitized many of its residents to the prospect of unexpected death.

But in his 1999 paper entitled "The Cultural Politics of Public Spectacle in Rome and the Greek East in 167-166 BCE" Jonathan C. Edmondson points out that when King Antiochus IV introduced Roman-style gladiatorial combats in Syria in 166 BCE, the Syrians were terrified rather than entertained.

"In time gladiatorial contests came to be accepted and even popular, but only after Antiochus had instituted a local variation whereby fights sometimes ended as soon as a gladiator was wounded."

This hardly sounds like people desensitized to death.

Recently, scholars studying cuneiform medical texts left behind by ancient Mesopotamians point to passages describing mental disorders expressed by soldiers and even a king during the Assyrian Period (1300� BCE) when military activity was extremely frequent and brutal. The King of Elam is said to have had his mind changed. Soldiers were described as suffering from periods where they were forgetful, their words were unintelligible, they would wander about, and suffer regular bouts of depression.

I also think scholars dismiss too readily the psychological aspects of PTSD in the ancient world because of their observations that the ancient world was a far more brutal environment than we have now (outside of inner city ghettos). They point out how people were surrounded by death because of disease, accidents without proper medical treatment, and entertainments that featured the orchestrated deaths of both people and animals. I propose that observed deaths occurring in a venue where the observer and the participants are separated both by physical barriers and social hierarchy (most human victims were criminals, prisoners of war, "Others" so to speak, or slaves, those whose social status separated them from the vast number of citizens in the audience) are distinctly different when compared to violent deaths of friends, family members, and comrades, your "band of brothers," fighting right beside you in a person-to-person battle scenario.

Furthermore, ancient executions were designed to further distance the audience from the victim through the use of mythological reenactments or by placement outside the city.

"Crucifixions were usually carried out outside the city limits thus stressing the victims rejection from the civic community. Because of the absence of bloodshed out of an open and lethal wound, which evoked the glorious fate of warriors, this type of death was considered unclean, shameful, unmanly, and unworthy of a freeman. In addition the victim was usually naked. Essential, too, was the fact that the victim lost contact with the ground which was regarded as sacrilegious." - J.J. Aubert, "A Double Standard in Roman Criminal Law?" from "Speculum Juris: Roman Law as a Reflection of Social and Economic Life in Antiquity"

We also cannot forget the medical personnel either. The medical environment of an ancient treatment facility following a major battle was far worse than in a modern field hospital. Ancient surgeons attempted to treat often thousands of wounded in a relatively short time compared to only handfuls at a time during the Vietnam conflict. Ancient physicians were surprisingly quite skilled, especially Roman military surgeons, but they had little but herbal compounds (and honey if the Romans listened to the Egyptian physicians) to ward off infections. Their patients' mortality rate was much higher than the relatively low mortality rate experienced in Vietnam.

I sometimes wonder, though, if modern scholars think that ancient people just didn't value their lives as much as we do, since they did not shrink from casualties as high as 50,000 in a single military engagement or investment of an enemy city. But if you've ever looked at some of the poignant grave goods found in ancient burials or studied the reliefs and inscriptions on ancient funerary monuments, I think you will conclude that we are only separated by time, not by our shared human nature.

This post is a condensed summary of a paper I wrote, "Concussion and PTSD in the Ancient World" back in 2013. You can read the full article at:


Soldiers described the effects of trauma as “shell-shock” because they believed them to be caused by exposure to artillery bombardments. As early as 1915, army hospitals became inundated with soldiers requiring treatment for “wounded minds”, tremors, blurred vision and fits, taking the military establishment entirely by surprise. An army psychiatrist, Charles Myers, subsequently published observations in the Lancet, coining the term shell-shock. Approximately 80,000 British soldiers were treated for shell-shock over the course of the war. Despite its prevalence, experiencing shell-shock was often attributed to moral failings and weaknesses, with some soldiers even being accused of cowardice.

An Australian soldier displaying signs of shell-shock (bottom left) Wikimedia Commons

But the concept of shell-shock had its limitations. Despite coining the term, Charles Myers noted that shell-shock implied that one had to be directly exposed to combat, even though many suffering from the condition had been exposed to non-combat related trauma (such as the threat of injury and death). Cognitive and behavioural symptoms of trauma, such as nightmares, hyper-vigilance and avoiding triggering situations, were also overlooked compared to physical symptoms.

Today, it is these cognitive and behavioural symptoms that define PTSD. The physical symptoms that defined shell-shock are often consequences of these nonphysical symptoms.

Every war, WWII included, has scarred its combatants’ psyches. Yet there remain those who look back fondly at the good old days of armed conflict, when iron-nerved men’s men simply shrugged off the tribulations of the battlefield. One might reasonably file such a misty-eyed take under the heading of nostalgia—a term, it so happens, that was coined in the 17th century to describe a mysterious ailment afflicting Swiss soldiers, making it the first medical diagnosis of war’s psychological effects. Many other names would be proposed for this condition over the years before the American Psychiatric Association put it in the books as post-traumatic stress disorder in 1980. The symptoms, though, have remained consistent: PSTD sufferers relive traumatic events, avoid situations that bring them to mind, endure negative feelings about themselves and others, and generally feel anxious and keyed-up.

No psych evals were conducted during the Trojan War, of course, but the U.S. Department of Veterans Affairs site finds literary antecedents for PTSD symptoms in Homer, Shakespeare, Dickens, and Stephen Crane. And mercenaries from the Alps stationed in the European lowlands had been suffering from bouts of anxiety and insomnia for some time before the Swiss doctor Johannes Hofer named their disorder “nostalgia” in 1688. Apparently stricken with a longing for their far-off homes (often triggered by the melodies of traditional cow-herding songs), these otherwise sturdy fellows supposedly fainted, endured high fevers and stomach pain, and even died. But though physicians now had a name for it, they lacked a cause—maybe the clanging of those infernal cowbells had damaged Swiss brains and eardrums, some suggested—and for treatment they fell back on standard remedies of the pre-ibuprofen era, e.g. leeches and opium.

During our own grisly Civil War, soldiers’ anxiety expressed itself in palpitations and difficulty breathing, a condition dubbed “irritable heart” or “soldier’s heart.” Some researchers, scrambling to find a physical mechanism behind the symptoms, blamed the way the troops wore their knapsacks, while the high-minded saw a spiritual failing—sufferers were seen as oversexed and prone to masturbation. Dr. John Taylor of the Third Missouri Cavalry expressed “contempt” for these soldiers’ “moral turpitude,” saying “gonorrhea and syphilis were not more detestable.” Classified (if not wholly understood) as “Da Costa’s syndrome” after the war, based on 1871 findings by Jacob Mendez Da Costa, the condition was treated with drugs to lower the heart rate.

The term “shell shock” came into use during the Great War, born of the belief that mortar fire had psychologically disoriented the boys. With unending need for trench fodder, the warring nations simply shipped 65 percent of traumatized men back to the front the more serious cases received electrotherapy, hypnosis, pr hydrotherapy—essentially a relaxing shower or bath. The psychological effects of World War I were so widespread that when the sequel arose, military experts hoped to curtail what they called “combat stress reaction” with intense psychological screening of combatants, believing they could ID those most likely to suffer.

They couldn’t. “Battle fatigue” plagued soldiers in World War II. Hard-asses would equate this condition with cowardice or goldbricking, none more notoriously than General George S. Patton, who on two different occasions slapped and browbeat afflicted soldiers for seeking medical care. But the problem was too widespread to ignore—a conservative estimate is that 5 percent of WWII veterans suffered symptoms we’d associate with PTSD, and as late as 2004 there were 25,000 receiving benefits for war’s psychological aftereffects. Stats for Korean War vets are a little harder to come by, but over 30 percent of the veterans who responded to a 2010 Australian study met PTSD criteria, with or without accompanying depression.

By midcentury the U.S. Army had come around to the idea thatto quote the 1946 film Let There Be Light, John Huston’s army-produced documentary about the causes and treatment of mental illness during WWII—“every man has his breaking point.” Still, the psychiatric community struggled with how to conceptualize PTSD. The first Diagnostic and Statistical Manual of Mental Disorders, from 1952, listed the condition as “gross stress reaction” again, it first appeared under its modern name only in 1980’s DSM-III, in part because of research on veterans returned from a war that wasn’t considered one of the “good” ones.

Thanks to this timing, PTSD will forever be connected with Vietnam vets, and in fact as many as 30 percent of them were diagnosed with symptoms at some point. But the numbers haven’t been much better for American conflicts since—between 15 and 20 percent. And, of course, civilians suffer as well. About 7 or 8 percent of all Americans will have PTSD at some point, though for women the number is closer to 10 percent. This presumably has less to do with any physiological differences between the sexes than with the greater likelihood of trauma, especially sexual assault, that women face. There are other kinds of hell than war. —Cecil Adams

Chris Kyle's PTSD: The untold, real-life "American Sniper" story

By John Bateson
Published February 19, 2015 11:28AM (EST)

Bradley Cooper in "American Sniper" (Warner Bros. Entertainment)


In his best-selling memoir, "American Sniper: The Autobiography of the Most Lethal Sniper in U.S. Military History," published in 2012, Navy SEAL Chris Kyle writes that he was only two weeks into his first of four tours of duty in Iraq when he was confronted with a difficult choice. Through the scope of his .300 Winchester Magnum rifle, he saw a woman with a child pull a grenade from under her clothes as several Marines approached. Kyle’s job was to provide “overwatch,” meaning that he was perched in or on top of bombed-out apartment buildings and was responsible for preventing enemy fighters from ambushing U.S. troops. He hesitated only briefly before pulling the trigger. “It was my duty to shoot, and I don’t regret it,” he wrote. “My shots saved several Americans, whose lives were clearly worth more than that woman’s twisted soul.”

Kyle was credited with 160 confirmed kills—not only an astounding number but an indication that the U.S. military today still considers counting dead enemy something worth doing. Kyle was so good at his job that Iraqi insurgents nicknamed him the “Devil of Ramadi” and put a bounty on his head. They never collected, but the war took its toll anyway. Kyle, who learned to shoot a gun before he learned to ride a bike, saw the face of his machine gun partner torn apart by shrapnel, witnessed another comrade die when an enemy bullet entered his open mouth and exited the back of his head, and lost a third friend when an enemy grenade bounced off his chest and he jumped on it before it exploded in order to save everyone around him. Kyle also was among the many Marines who were sent to Haiti in 2010 to provide humanitarian relief following the devastating earthquake there. According to Nicholas Schmidle, whose lengthy profile of Kyle appeared in the New Yorker in June 2013, Kyle was overwhelmed by all the corpses in Haiti that were piled up on roadsides. He told his mother afterward, “They didn’t train me to go and pick up baby bodies off the beach.”

These and other experiences led to many sleepless nights when Kyle returned home, as well as days in which he lived in an alcoholic stupor. It didn’t help that in each of his sniper kills, Kyle could see through the lens on his rifle, “with tremendous magnification and clarity,” wrote Schmidle, his bullet piercing the skull of his target.

According to his medical records, Kyle sought counseling for “combat stress” after his third deployment. Like most soldiers, however, in his exit physical he said he had “no unresolved issues.”

Kyle longed to return to the war, to the world he knew the best, where everything made sense and he was in the company of others who understood him and appreciated his talents. His wife, however, said that if he reenlisted she would take their two young children and leave him. Trying to find a sense of purpose outside of combat, Kyle participated in various activities for veterans, primarily hunting trips. In addition, he started a company that provided security at the 2012 London Olympics, helped guard ships near Somalia from pirates, and served briefly as a bodyguard for Sarah Palin.

When Kyle was approached by the mother of a distressed 25-year-old Iraq War veteran named Eddie Ray Routh, who was suffering from PTSD and taking eight different medications, Kyle agreed to help. He told Routh that he, too, had had PTSD. In February 2013, Kyle and a friend drove Routh to a gun range near Kyle’s home in Texas. Kyle thought that shooting a firearm might offer some kind of therapy for Routh. Instead, Routh shot and killed both Kyle and his friend with a semiautomatic handgun before fleeing in Kyle’s pickup truck. Afterward, Routh told his sister that he killed the two men before they could kill him and that he didn’t trust anyone now.

From an outside perspective, it’s difficult to believe that a combat veteran like Routh would think he couldn’t trust one of the most revered soldiers in recent years, a man who gave his time freely to assist other veterans. Yet Routh learned from his training as well as from his own experiences in war that many people who seemed friendly or innocent really weren’t. While it’s rare for this distrust to include a soldier’s comrades, when one’s mind is warped by a combination of trauma and a cocktail of pharmaceuticals, nearly anything can happen. Seven thousand people, including Palin and her husband, attended Kyle’s memorial, which was held at Cowboy Stadium. Routh is now on trial for the two murders.

Killing others is morally reprehensible and a grievous sin. It’s also criminal, but not in war. In no other setting are people trained to kill on sight, no warnings issued or questions asked. The rule of thumb is to shoot first, and deal with any moral uncertainties later. As Tony Dokoupil notes, however, the word killing “doesn’t appear in training manuals, or surveys of soldiers returning from combat, and the effects of killing aren’t something that the military screens for when people come home.”

Excerpted from "The Last and Greatest Battle: Finding the Will, Commitment and Strategy to End Military Suicides" by John Bateson. Published by Oxford University Press. Copyright 2015 by John Bateson. Reprinted with permission of the publisher. All rights reserved.

John Bateson

John Bateson is the author of The Final Leap: Suicide on the Golden Gate Bridge. For more than 15 years he was executive director of a nationally certified suicide prevention center in the San Francisco Bay Area. He served on the steering committee of the National Suicide Prevention Lifeline and was part of a blue-ribbon committee that created the California Strategic Plan on Suicide Prevention.

War Veterans and Post Traumatic Stress Disorder (PTSD)

Those who survived a war, are often scarred for life by their experiences. Many suffer problems, including the condition known as Post Traumatic Stress Disorder (PTSD).

It took considerable time for the medical and mental health professions to connect the persistent symptoms of depression, anxiety, chronic insomnia, jumpy body movements, terrifying nightmares, inability to keep a job (resulting in living on the streets), aggressive behaviour, alcoholism, drug abuse, personality changes, difficulty with relationships, a rise in divorces, the high rate of imprisonment and an unacceptably high level of suicide amongst veterans of Vietnam and other war areas, to a disorder now known as Post Traumatic Stress Disorder.

PTSD was officially recognised in 1980 but it took years before it was more generally known and accepted as the debilitating disorder that it is – and while much work is being focused in this area – it is still not yet fully understood.

So many persons came home from war zones suffering from confusion, guilt, anger, shame and sorrow. Many of these persons simply could not cope with the awful burden of such intense feelings – hence the development of the symptoms listed above. PTSD is not easily recognised or treated since people react differently to traumatic stress and the effects of such stress cause a multitude of problems which effectively prevent the sufferer from pursuing a normal life.

The treatment of PTSD has changed radically and work is being done on many fronts to help such persons. Since each person reacts differently to stress, not everyone involved in war or other traumatic situations needs help. There are many veterans living perfectly normal lives. PTSD affects not only War Veterans, but ordinary citizens and even children. It can happen to anyone who has experienced major trauma in their lives, such as for example, as a result of an accident, assault, disaster or death.

Unfortunately, a huge number of vets suffer from some level of PTSD, which possibly explains the large percentage of veterans who are in jail. Shad Meshad (Founder of the National Veteran’s Foundation), himself a Vietnam veteran, noted that 2600 veterans were in the Californian Prison system out of a population of 13500 persons. He further noted that 22 suicides per day are committed by veterans. In order to help PTSD vets, Shad’s National Vet Foundation created a Live Chat website to allow veterans create their own support network.

Information is made available of where and how to get professional help and a Hotline is also available for those in dire need. Shad started counselling groups for Vets In Prisons (VIPs) where they could share their experiences. “Sneaky” James White – a vet who has been in prison since 1978, attended a VIP meeting and became so inspired that he began setting up VIP counselling groups wherever he was placed. He encouraged vets to share their troubles and fears and to support and listen to one another. He encouraged them to study further and to become counsellors themselves. Sneaky is much admired for his commitment to the improvement of the lives of all those around him.

Much is being done to help these PTSD sufferers – on many fronts. In the medical and psychological fields, new methods of treatment are being introduced and many are proving to be reasonably successful.

Psychotherapy, the most common approach, includes, among others, cognitive therapy (encourages improved ways of thinking) and exposure therapy (facing one’s fear) where sometimes Virtual Reality programmes are utilised. Another therapy is that of Eye Movement Desensitisation and Reprocessing (EMDR), which is aimed at helping to process traumatic memories so that they can be handled by the sufferer.

It has been found that sufferers often require more than one approach, so most therapies are used in conjunction with other therapies or methods. Many of the therapies need to utilise various drugs for the control of depression, anxiety, insomnia and nightmares.

Dr Kate Hendricks Thomas, a Marines Veteran and a Public Health researcher, is convinced that “pills and therapies are not enough to return this active, passionate community [marines and soldiers] to health after trauma” She had long struggled with her own problems before finding that a study of Yoga meditation was a solution for her. She had grown up in the military field and knew the life intimately. On returning from Vietnam she found herself fighting to control her physical aggression – to the point where she even had to hide her gun.

Her personal relationships were radically affected – so much so, that at one time she felt she could have appeared on a Jerry Springer show! She found that working towards the goal of creating mental fitness and resilience with yoga meditation and other techniques saved her life. She became a trained Yoga instructor and teaches Yoga methods to groups of veterans suffering from various forms of PTSD. She feels that these military persons, since they are so competitive, respond so much better to a challenge. As she could relate to their sufferings – she gained the trust of her students.

It appears that a number of PTSD practitioners can attest to the value of yoga and yoga-like meditation practices and techniques, having also noticed significant positive improvements in many of their patients.

A recent assessment seems to indicate that a large number of veterans with Post Traumatic Stress Disorder still suffer major depressive disorders and seem to be deteriorating rather than improving. This may well be due to aging, retirement, chronic illness and declining social security as well as the ongoing difficulties with the management of unwanted memories. Perhaps they too can be helped by practising meditation and breathing exercises.

More practitioners dealing with PTSD veterans seem to be favouring the multi-faceted approach, combining various therapies and techniques tailored to each individual’s particular symptoms and requirements. One is heartened to know that this multi-faceted approach is having great effect and thus gives us hope for the challenges that may well lie ahead with the veterans from Iraq and Afghanistan.

Watch the video: Could you have Posttraumatic Stress Disorder PTSD?