Treating soldiers as victims

Former British troops claiming to be suffering from post-traumatic stress disorder have lost their battle for compensation. But how did the case get to court in the first place?

Ellie Lee

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A 19-year-old man walked into a village, breathing in smoke and dodging crossfire, to see a pregnant woman tied to a post with her belly ripped open and a dead dog stuffed into the cavity….

This is one of the horrifying scenes witnessed by British troops, and cited in a court case brought by ex-soldiers against the Ministry of Defence (MoD) at the High Court in London. The lawsuit involved almost 2000 potential claimants, but the court hearing focused on 15 ‘lead’ cases, which were prepared in order to illustrate the central issue of the case – that the British military inadequately prepares its forces for the aftermath of war, causing many to suffer from post-traumatic stress disorder (PTSD).

The former troops, who served in the Falklands, Northern Ireland, Bosnia and the Gulf, lost their case today, 21 May 2003. But this is unlikely to be the end of the matter. The court ruling accepted that the MoD did all it could to protect troops in the circumstances of past conflicts, but it agrees that PTSD is a problem of soldiering. So this case does not preclude future claims by other soldiers. And according to a recent Guardian report headlined ‘After the war, a fight for justice’, British law firms are already ‘anticipating a large number of claims from servicemen returning from [Iraq]’.

Even the MoD, while welcoming the court’s decision, says that it will ‘continue to follow the latest medical guidance on diagnosis and treatment of PTSD’. The MoD promises to ‘monitor and raise awareness of PTSD and other stress-related disorders that may occur among service personnel at any time’. This specific case might be over, but the issue of PTSD in the military is likely to run and run.

Why now? Soldiers have always witnessed terrible scenes, and many have no doubt found it difficult to reintegrate into civilian life after war. But this is the first time that soldiers have brought a case against the MOD, seeking financial recompense for the effects of their experiences.

The case centred on claims that the MoD failed to do all it could to minimise the risks of soldiers suffering psychological harm, and failed to provide sufficient post-conflict care. Many of the claimants argue that their lives have been ruined as a result of serving in the military. A Navy officer who served in the Falklands claims that he lost the ability to communicate properly with loved ones. ‘I lost my wife because of it’, he said. Another claimant said: ‘I wish I’d never joined the army.’

These comments reflect a sense that war just isn’t worth it. The logic seems to be that if wars cannot be made risk-free, then it’s not worth the risk of fighting them. Many now seem to view being in the armed forces as ‘just a job’, and the MoD as just an employer. Indeed, the court case rested on this very idea. As Combat Stress, the organisation for ex-military personnel with mental health problems, pointed out, service personnel now have the right in law to sue the MoD, just as everyone else has the right to sue civilian employers for breaching their duty of care.

This approach represents a significant shift in how individuals view signing up for military service. There seems to be less and less sense of any ‘greater good’ that it might be worth fighting, and possibly even suffering, for. Instead, troops today seem to have an increasingly individuated experience of war.

Consider the Falklands conflict, some of the veterans of which were involved in the action against the MoD. When the Falklands War was fought in 1982, many considered it to be a ‘good fight’, the British military’s stand against dictatorship and tyranny. Now, such broad claims ring hollow, and any idea that the war was worthwhile appears to have vanished. In the absence of a sense of purpose to a conflict, it isn’t surprising that troops are prepared to blame and claim.

Beyond troops’ own experiences, there are broader cultural and social trends impacting on how we perceive wars and their impact today. Indeed, many of the reactions to the High Court case betray modern Britain’s deep-seated ambivalence about fighting wars.

‘What did they think it would be like?’ has been the response of many people I have talked to about the case. This seems to be an obvious point: that if you sign up for the army, then you will most likely witness some terrible things. But this kind of response also suggests a big gap between the general public and those who go to war. There appears to be a palpable incomprehension of, if not contempt for, those ‘stupid’ enough to join the army and to believe that there is something possibly worth dying for.

This response suggests that the notion that soldiers sent abroad are doing something for those back home has less purchase than ever. Troops are not necessarily seen as ‘Our Boys’, but as foolish individuals who should have known what they were getting themselves into. This sentiment often appears less as a principled opposition to war, than as an expression of cynicism about why anyone would die for his or her country.

Another response is to agree that the MoD has neglected its responsibility to its ‘employees’. This reaction, too, suggests that there is little to identify with in Britain’s wars, and flagging up the suffering of individual soldiers becomes the means through which this sentiment is expressed. In the 1970s, some people used to wear badges saying ‘War is bad for children, flowers, and other living things’. It seems that this list has been extended to include those whose job it is to fight wars.

It was this kind of sentiment that gave rise to the category of post-traumatic stress disorder in the first place. PTSD was first named as a specific psychiatric illness in 1980. The story of PTSD is a complex one – but most studies indicate that that this ‘illness’ was not so much discovered, as invented.

It was America’s Vietnam veterans whose experience first gave rise to notions of PTSD. No doubt many US troops experienced psychological problems when they returned from Vietnam. But the majority of serious studies into PTSD show that the representation of these post-conflict problems in terms of psychiatric illness – which meant that those suffering such illnesses could claim compensation from the US government – really constituted a way of showing opposition to the war.

According to Simon Wessely, an expert on psychiatry and the military and head of the Gulf War Illnesses Research Unit at King’s College London, PTSD emerged, not as the result of ‘any careful hypothesis, epidemiological investigation or even serendipitous inquiry’, but ‘in response to America’s own traumas associated with the Vietnam War’. Wessely says that PTSD was created ‘consciously and deliberately’ by a section of the mental health community, and research tended to follow suit.

Stephen O’Brien, author of the 1998 book Traumatic Events and Mental Health, describes the emergence of PTSD in broad terms, as an association between fighting in Vietnam and veterans’ ‘social problems, poor integration in society, criminal behaviour and mental health problems’. One crucial factor in bringing these things into association was the political and campaigning activities of those who took up the veterans’ cause – in particular anti-war activists, and psychiatrists and social workers who were opposed to the war.

At the time of the Vietnam War, many were hostile to the attempts to psychologise the effect of conflict on soldiers. Ben Shepherd’s A War of Nerves, published in 2000, argues that psychiatrists in the 1960s and 70s, in their responses to what was then known as ‘Post-Vietnam Syndrome’, divided into ‘doves’ and ‘hawks’. The hawks saw the idea that war leads to mental illness as the elevation of the ‘pathological into the mainstream’, and talked about the destructive consequences of this view for the armed forces.

The doves, by contrast, believed that mental illness resulting from catastrophes was a problem of major proportions, which could have disastrous social effects. As one psychologist put it: ‘“Dovish” psychiatrists and other practitioners believed that emotional disorders among returning veterans could reach epidemic proportions…post-Vietnam syndrome became a frightening buzzword among clinicians and journalists, but in fact was a thinly veiled position of opposition to the war.’

Those who advocated a new disease category won out. According to Ben Shepherd, the impact of PTSD was that ‘the balance was shifted between trauma and victim, putting much greater emphasis on victimhood than endurance’. PTSD advocates’ central argument was that the Vietnam vets’ feelings and experiences – alcoholism, marital problems, nightmares – were not an acceptable outcome of war, or an indication that some individuals could not cope. Rather, they showed that war resulted in psychiatric illness.

As one writer summarises: ‘This [new] orientation shifted the focus of the disorder’s cause from the particular details of the individual soldier’s background and psyche to the nature of war itself. Its advocates claimed: soldiers disturbed by their combat experiences are not, in an important sense, abnormal: on the contrary, it is normal to be traumatized by the abnormal events of war.’

It is not only changes in the perception of war that made something like the High Court case possible today. Many now seem to believe that difficult life events ‘scar for life’ – that is, they can cause us to suffer from ‘post-traumatic stress’.

PTSD was first ‘named’ in 1980. At that time it was viewed as rare and unusual, something that might affect small numbers of soldiers and others involved in extremely dangerous situations. But the diagnosis of PTSD has rapidly expanded in recent years. The term frequently appears in medical literature.

A search of online data services found over 50,000 indexed references to PTSD. British psychiatrist Derek Summerfield notes that the National Center for Post-Traumatic Stress Disorder in the USA, which tracks journal articles, books, and technical reports on PTSD, had by September 1999 indexed more than 16,000 separate publications.

It seems that we are all potential victims of PTSD now. According to a report from the Food and Drug Administration, more than 10million Americans a year (about four per cent of the population) ‘experience the life-disrupting symptoms of PTSD’ – although the National Institute for Mental Health puts the figure at 5.2million. The result of all of this, in the words of American authors Herb Kutchins and Stuart Kirk, is that PTSD has become the dominant label ‘for identifying the impact of adverse events on ordinary people’.

In Britain, psychiatrists started to diagnose PTSD in those involved in major accidents and tragedies in the 1980s. PTSD became a big issue in Britain in 1985, when it was diagnosed in firefighters who tackled a fire at Bradford football stadium that killed 36 fans. After the 1987 fire at King’s Cross train station, and the major disaster at Hillsborough football stadium in 1989, where 95 fans were crushed to death, there were a plethora of PTSD diagnoses among both survivors and service personnel.

In Britain, unlike in America, PTSD did not emerge in the context of war. But by the late 1990s, it was viewed as a condition of everyday life – in Britain as much as in the USA. Some now argue that you can ‘catch’ PTSD from watching scenes of death and destruction on TV. In such a culture, it isn’t surprising that there is a growing acceptance that soldiers become ‘damaged goods’ by fighting in wars.

The dynamics behind the soldiers’ claims and the view that war damages those who fight in it have nothing to do with real opposition to war. Rather, they expose the lack of mission at the heart of modern society, and the spread of risk aversion and notions of victimhood into ever-more spheres of life.

Ellie Lee is a research fellow in the Department of Sociology and Social Policy at the University of Southampton

Read on:

The invention of PTSD, by Ellie Lee

Gulf War Syndrome – the sequel, by Brendan O’Neill

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