Walt Whitman was haunted by the images of death and destruction long after the Civil War ended. In his poem, “Old War-Dreams,” he wrote: “of their forms at night, I dream, I dream, I dream.” Lingering traumatic images are one after effect of combat stress, along with a host of other symptoms.
While the physical and mental effects of combat have always been a reality for the Soldier, what we call these effects has changed over time.
Soldier’s Heart
In the Civil War,we called it Soldier’s Heart. Civil War physicians and psychologists debated over whether Soldier’s Heart was an affliction of the heart muscle or merely a neurosis of the mind. In Vietnam, it was called Shell Shock. This condition was attributed to the effects of the loud, virulent noises of war. Today we call it Post Traumatic Stress.
A Name Does Matter
It might be easy to dismiss this debate as a name game. But it turns out that what we call combat stress can help or hinder its treatment. In a study done at DePaul University, researchers found that medical personnel were likely to perceive an illness as more severe depending on the sound of its name, even when presented with identical cases. Researchers also found that when a name was considered to be psychosomatic—or stemming from the mind—they were less rigorous in their treatment suggestions. If medical personnel can be influenced by a name, so can society.
Stereotypes and Stigmas
A hallmark study published in the New England Journal of Medicine showed that Soldiers worried how peers and leadership would perceive a diagnosis of Post Traumatic Stress. In fact, it bothered them so much it was a significant barrier to seeking treatment. The study showed there was a connection between the two. Those who needed help the most where least likely to seek it because of how other people would see them. It seems a name can effect perception, and perception can affect treatment—in the end, we are all susceptible to the fear of being judged.
One reason the stigma of Post Traumatic Stress is so strong in military culture is because it involves shame—shame of weakness and shame of letting others down. In an interview with Frontline, Dr. Friedman, the Executive Director of the Veteran Affairs National Center for Post-Traumatic Stress Disorder, explains that there is no shame associated with having a physical illness. However, significant stigma exists around illnesses such as depression or anxiety. The roots of these stigmas stem from within the larger society, not from within the military. Yet, Dr. Friedman points out, military culture can heighten the issue because many situations require Soldiers to entrust their lives into each other’s hands. Soldiers want to be perceived as being trustworthy and dependable, not a liability to the unit’s safety.
Education is Key
The only way to overcome this barrier to treatment is through education. Research on combat stress has come a long way, proving its effects are not just in the Soldier’s mind. There are physical and emotional effects of Post Traumatic Stress, and science can no longer hold that what happens to the body is separate from what happens to the mind. Dr. Friedman also reminds us that Post Traumatic Stress is not a problem isolated to the military. From firefighters to police to emergency medical personnel, there’s a possibility of experiencing intense stress or trauma while on the job.
No matter what we call it, and no matter how it happens, overcoming treatment barriers to Post Traumatic Stress is everyone’s problem. Fear of being judged, the stigma of seeking help, and the shame of these invisible wounds can all be overcome when the attitude within our culture begins to change to one of understanding and acceptance.