Warning: The issue of PTSD is contentious and fraught with emotion. The purpose for writing this article is to shed some light on a subject that is poorly understood with the hope of offering some practical thoughts for leaders who have the privilege of leading men and women in combat. I have been lucky. I do not have PTSD but I know a great many people suffer from it. I hope that by offering some thoughts on the subject, I might contribute in some small way to preventing more cases in the future.
Thank you to Mark Budd for helping me to consider the issue.
Looking to the Extremes
I believe that you can learn a great deal about the human condition by studying the extreme ends of the spectrum. If you want to understand grit and resilience, the best place is to look is where human suffering has been the most extreme; the holocaust. Victor Frankl’s ‘Man’s Search for Meaning’ and Primo Levi’s ‘If this is a man’ explain with graphic brutality what man is capable of – but they also explain how people survive under such conditions.
If you want to understand leadership, warfare is a good place to start because the role of the leader is magnified. On the battlefield, leadership failure is measured in lives and casualties. Those who have served understand that the Military ‘gets this’. If I take the Royal Marines as an example, they’ve learnt these lessons and developed their approach to leadership over 350 years. The average age of a S&P 500 company is just 25 years – the level of understanding of leadership and its impact just hasn’t reached the same level of maturity.
The challenges faced by leaders on the battlefield aren’t the same as the ones faced by leaders in the boardroom but there are principles that apply to both environments. If you want to become a better leader in either arena, it is worth studying good and bad leadership in a wide-range of contexts. Learn what works in other areas so you can apply it to you own.
I have been a fan of Sebastian Junger’s work for a couple of years now. His documentaries (Restrepo and Battle Company Korrengal) are thoughtful and intelligent. They give some of the best explanations of what it is like to be in combat. Junger’s book ‘Tribe: On Homecoming and Belonging’ raises some uncomfortable points about the loneliness of western society. He makes the point that from an evolutionary perspective, we are so used to dealing with a threat to our existence, removing it has made us feel less connected to each other, less of a tribe.
Junger tells the tale of the Blitz in 1940 and 1941 when London was being hammered by the Luftwaffe. The Government at the time thought that as a nation we were going to have to deal with massive psychological casualties after the Blitz. They expected people to take advantage of the disorder and for crime to rise. In reality, the opposite happened. People stuck together. They helped each other deal with this threat providing support and warmth. This created close societal bonds that were missed after the war. People missed ‘the spirit of the blitz.’
Junger’s work and a subsequent recommendation by Mark Hardie led me to discover ‘Achilles in Vietnam’ by Jonathan Shay.
The book takes Homer’s tale of the Illiad and contrasts it with the experience of soldiers in Vietnam. Shay is well placed to write such a piece as he has done an enormous amount of work with Vietnam veterans who have suffered, often silently, with PTSD since the war.
Vietnam veterans are unique in that so many of them have struggled to re-adjust to society. Veterans sampled in the National Vietnam Veterans Readjustment Study found that 40% had committed more than three acts of violence in the previous year.
Think about that for a second. More than three violent incidents in a year is a lot. 40% is a lot. Combine the figures and you get a sense that there are a generation of veterans who have been really struggling since their war.
Shay approaches this problem with a desire to understand and learn. Understand why so many Vietnam veterans are struggling – and learn how we can prevent such circumstances from occurring again.
Shay argues that the central theme of the Illiad is Achilles’ character is ‘undone’ by the death of Patroklos. His experience of working with Vietnam veterans is used to draw parallels between the wars. The book makes difficult reading but I recommend that you do read it especially if you have led or are likely to lead men in combat.
Practical Solutions
The obvious way to eliminate PTSD is to eliminate the conditions that create it. For the soldier, that would have to mean the end of war and although I believe pacifists are honourable in their intent, what their philosophy practically leads to is surrender to the world’s bullies.
If we can’t remove the threat of war and we accept that we are going to send men to fight on our behalf, we have to consider what we can do to minimise the risks of creating psychological casualties.
Below are some themes that come out of the book. I deliberately have chosen to highlight only a few because if you’ve read this far, you need to read Shay’s book.
Equipment
The soldiers in the Illiad brought their own armour and weapons to fight in the war. This equipment would have been considered valuable and handed down through the generations. In Vietnam and in the modern era, equipment is provided by the State. The responsibility for high quality equipment is part of the moral contract that the State enters with its soldiers. ‘We will give you the tools to do the job’. Problems arise when the ‘tools’ are not good enough. In Vietnam, the US Military were issued the M16 A1, it had reliability problems from the start.
We left with 72 men in our platoon and came back with 19, Believe it or not, you know what killed most of us? Our own rifle. Practically every one of our dead was found with his (M16) torn down next to him where he had been trying to fix it.
Marine Corps Rifleman, Vietnam. “Defense: Under Fire”. Time Magazine, 9 June 1967.
Giving soldiers good quality equipment to enable them to do the job is essential. If soldiers are going to be asked to potentially make the greatest sacrifice, they have to be adequately equipped. Equipping the military is not a political opportunity to create jobs if the end-product is not good enough and creates the conditions for the belief that ‘the government do not care.’
The UK Government made mistakes when they replaced the SLR with the SA80 A1. It was great on the range but a poor battlefield rifle where the ability to keep it immaculately clean wasn’t always possible. Fortunately, the A2 is significantly better but that’s because it’s basically a Heckler and Koch weapon.
Training
Many soldiers fighting in Vietnam felt their training was unsuitable for fighting in the jungle. When they deployed, they felt completely unprepared and had to learn new tactics techniques and procedures from the soldiers who’d been in country for longer. I understand that some of this is inevitable as warfare is a constant cycle of adaption and innovation as the opposing forces learn from each other. However, if you believe your training to be almost entirely useless, it contributes to the sense that you’ve been poorly prepared for the job.
When I was taught how to do magazine changes, the routine was to remove the magazine and place it down the front of your combat jacket. As soon as we deployed to Virginia in the US, it was too hot to wear combat jackets and we were live firing in body armour. We were dropping magazines all over the place because this tactic simply didn’t work. When we deployed to Afghanistan, Marines that had been there before us told us to get ‘dump pouches’ (a box shaped compartment strapped to the side of the leg with an elastic opening) so we could ditch magazines and move without using them. These guys had been in combat firing several magazines in a firefight. They taught us a new procedure because the old one didn’t work.
Support of the Public
Soldiers need the support of the public. Without it, they can become disillusioned at the investment they’ve put in fighting a campaign. In WW2, the public understood the threat faced by the Axis powers. They supported the soldiers who were sent to fight. Contrast this with Vietnam and arguably many of the campaigns since.
Vietnam was meant to be a pre-emptive conflict to stop the spread of communism. The war was fought on the assumption that communism would spread through South East Asia and eventually become a significant threat to the US. The trouble is, that if the public are unconvinced of that assumption, it makes it difficult to understand the case for war and support the soldiers fighting it.
The UK Public have come along way in terms of supporting the troops. Help for Heroes and other charities have delivered great benefits to servicemen and women who’ve served in Iraq and Afghanistan. The challenge will be to maintain that level of support as the public and political will to use the military to fight overseas continues to wane. Keeping the military and the valuable work they do in the spotlight is essential in reinforcing the relationship between the Armed Services and the public.
Protect Unit Cohesion
The soldiers that went to Vietnam were individually rotated in and out of theatre. This meant that they did their training and arrived on the front as the ‘f**king new guy’. They were immersed into an already stressed unit on their own. They went on RnR alone. They returned home, alone.
Contrast this with the soldiers that fought in WW2. The majority of them trained together, fought together and came home together. This meant that the sense of brotherhood they developed in training and combat was kept throughout. If they were have problems, there were people that knew them and were able to spot when they were out of sorts. They knew people and could talk to them.
The lonely veteran by contrast has no one to talk to about the shared experience because the bonds of brotherhood are fractured when they’re individually rotated out of theatre. Protecting unit cohesion, keeping the men together is important in helping to create the conditions required for them to share the psychological burden.
Respect the Dead and Valuing Grief
In Vietnam, soldiers on both sides did not respect the dead. It was not uncommon to hear of bodies of enemy combatants being desecrated and mutilated. This loss of discipline was tolerated. The psychological consequences of this behaviour left survivors on both side with tremendous feelings of guilt when they returned home. Contrast this behaviour with the scenes in the Illiad. During the night, the fighting stopped and both sides removed their dead from the battlefield to bury them.
Grief is the natural way in which we process loss. People deal with it differently but as Shay states, ‘sincere and intelligent thought must be given to how we deal with death’. He makes the point that this is not something to be passed to the Chaplain; it is the responsibility of the tactical leader from JNCO to Major. Handling the dead with respect and creating communal rituals to honour them are important.
Beserking
Beserking is the act of uncontrollable violence where the berserker pays little attention to their own safety. The best description I can think of is the scene from The 300 when the Captain loses his son. He is focussed purely on revenge and does not care what happens to him.
In Vietnam, this state was encouraged in US soldiers. ‘Taking it out on the enemy’ was viewed as acceptable or even to be encouraged. The long-term psychological impacts of beserking are poorly understood though because it is impossible to create a controlled study from which we can learn. Regardless, Shay’s experience with his patients suggests that beserking has significant long-term negative consequences for the individual.
Conclusions
These are just a few of the themes that Shay shares in his book. This article was never meant to be a summary of his work, merely a way of drawing people’s attention to something that is topical given our recent involvement in Iraq and Afghanistan.
The Vietnam Veterans have suffered and are still suffering because of their experiences in the jungles of South-East Asia. The evidence suggest that there are certain characteristics of this conflict that make the veterans more susceptible to PTSD.
Understanding these characteristics and considering how to mitigate against the risk of psychological trauma is a leadership responsibility for those that will lead or send men to combat. I hope that this article helps shape your thinking on a subject that is only going to become more relevant in the future.
Regard your soldiers as your children, and they will follow you into the deepest valleys; look on them as your own beloved sons, and they will stand by you even unto death.
Sun Tzu