Combat, mental health, and uncomfortable questions

After the recent (latest) military base shooting, the V.A. urged the media and people generally not to jump to conclusions — suggesting that the shooter suffered from PTSD — that might further stigmatize mental health problems facing some veterans. In the abstract that might make sense, but in context it doesn’t quite. Because that request almost implies that there isn’t any connection — that it’s a myth. Which unfortunately is not the case…

In a Slate article headlined, “PTSD Contributes to Violence. Pretending It Doesn’t Is No Way to Support the Troops”, combat Marine officer-turned-journalist, David J. Morris, looks at historical links between war, PTSD, and home front violence and poses the uncomfortable question:

What if Dept. of Veterans Affairs isn’t trying to protect its veterans from being maligned/marginalized when they tell people not to link shooting sprees and veteran homicides with PTSD — and is really just trying to whitewash the fact that the country sent a bunch of people into very unusual moral situations (and then didn’t help them re-adjust when they got back)?

We absolutely need to do better, and certainly not everyone comes home messed up permanently. But refusing to acknowledge the lasting mental health toll of war for many veterans doesn’t mean it doesn’t last.

The simple fact is that war poisons some men’s souls, and we aren’t doing our veterans any favors by pretending that war is only about honor and service and sacrifice and by insisting that PTSD is completely unrelated to the problem of postwar violence. It’s not only morally irresponsible, it’s scientifically inaccurate.

To be perfectly honest, I don’t want this to be true. In fact, as a veteran who has struggled with post-traumatic stress, I hate that it’s true, but war is an evil thing. As a society we need to face the reality of it head-on so that we can avoid the next war. And despite its official protests to the contrary, the VA secretly agrees with me. Visit any VA hospital across the country and you’ll see what I mean. What’s the first thing you see when you walk in? A metal detector with an armed VA police officer standing nearby.”

If you really want to approach mental health better, there are other ways to do it that don’t include erasing linkages.

In many ways, the V.A. may be correct in de-coupling the two (PTSD and violent outbursts) in the sense that the former does not always bring the latter — although Morris brings a lot of data suggesting it certainly seems to bring it a lot of the time — but it’s also important to understand that violence can grow out of untreated mental health issues (among many other sources).

Another recent Slate article titled “Violence Is Not a Product of Mental Illness. Violence Is a Product of Anger” argues that violence comes from anger mismanagement, which is not necessarily related to having a mental health disorder or other problem (unless you count the angry outburst habit itself as a disorder). So, for example, someone could have anger management issues entirely unrelated to their mental disorder (and even predating it, in the case of a developed disorder such as PTSD — something Morris does acknowledge with cases of soldiers who had problems before they joined up in the first place). That’s definitely true in some cases.

At the same time, though, there can be a causal connection in other cases. Violence can be (even if it isn’t always) a product of extreme frustration with not being able to cope with or communicate to others the experience of facing a particular mental health struggle, diagnosed or otherwise. When symptoms are properly treated/managed and those suffering from them are given counseling resources, they’re far less likely to experience such extreme frustration that they go into violent rages.

So in that sense, the mental illness doesn’t cause the violence, but the mismanagement of the illness and (frustration resulting from it) do — a viewpoint that closes the loop on that article’s claim (essentially the same as the V.A.’s, I guess) that “Violence is not a product of mental illness” but rather of anger. And in that respect, we again see a need for additional counseling services for veterans and civilians alike in helping to manage their anger/frustration, whether it be from their mental health struggles or entirely unrelated pre-existing or external sources.

I’m absolutely in favor of the government devoting more resources to those services… for veterans, for prison inmates, and really for anyone who needs them. We would have far fewer social problems in this country right now if mental health treatment access were a guaranteed right to every citizen — and if stigma were substantially reduced.

But beyond that, there’s still the “exceptional morality” problem of saying “Thou shalt not kill, except…” As Morris suggests, it might be worth considering how combat experiences affect moral judgment and ability to evaluate proportional responses.

He’s largely conceptualizing it in terms of some people’s overall moral frameworks being warped by the experiences and by the confusing message of being told it’s ok to kill when the government tells you to. But I wonder if there could be a physical developmental issue too, considering who many of the participants are. I mean, if we worry about college students’ binge drinking and hard partying affecting their brain development as they cross from adolescence into adulthood, then why are we willing to pretend that we can send 18-22 year olds (the same age bracket) into situations where they might have to take people’s lives for their country or their own safety and have them all come out mentally and developmentally unscathed? The experiences could literally be reshaping the brains of some of the youngest veterans. We don’t know that for sure, of course, because we have been so unwilling to ask, i.e. to do lots of studies.

It’s uncomfortable to ask these questions because few among us are willing to make these big sacrifices and risk their lives to serve — I know I wouldn’t last a week in training, let alone in combat — but just because it’s uncomfortable and just because their service is commendable doesn’t mean we shouldn’t ask these questions. Not asking them doesn’t help those most affected get the treatment and counseling services they need to make sure they don’t act in violent ways against themselves or others.

Bill Humphrey

About Bill Humphrey

Bill Humphrey is the primary host of WVUD's Arsenal For Democracy talk radio show and a local elected official.
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