On Combat

“That which does not kill us makes us stronger”
–Nietzsche

“For most trauma survivors, posttraumatic growth and distress will coexist, and the growth emerges from the struggle with coping, not from the trauma itself”
–Dr Richard G. Tedeschi and Lawrence Calhoun

News coverage of the human cost of war justly concentrates on the plight of veterans grappling with the psychological costs of war. Mental health assessments report one in six soldiers suffer from acute stress symptoms, depression, or anxiety after return from combat.

Psychological casualties of war are real and we have the obligation to care for these wounded warriors. Unfortunately, despite our best efforts, we still have a long way to go in solving difficulties with access and availability of mental health care. We also have cultural barriers to cross in de-stigmatizing use of mental health services among our troops.

An exclusive focus on mental health difficulties suggests psychological injury is an inevitable outcome of combat. Some have described this undue focus as creating a “culture of victimization.” If combat results in an inescapable slide to psychological casualty, why are veterans of combat sought by commanders of units returning to battle?

Combat veterans have enhanced cognitive skills to help face situations experienced in battle, but can also have emotional growth that gives them greater mental resiliency. Battle changes all who experience it, but not all those changes are bad ones. If we take the glass is half full perspective on many studies of psychological injuries, the majority of those in battle do not suffer from acute stress, depression, and PTSD.

There is a body of research indicating the possibility of Post-Traumatic Growth. According to an article in the Psychiatric Times by Ph.D.s Richard Tedeschi, and Lawrence Calhoun, Ph.D., “In the developing literature on posttraumatic growth, we have found that reports of growth experiences in the aftermath of traumatic events far outnumber reports of psychiatric disorders

“These changes include improved relationships, new possibilities for one’s life, a greater appreciation for life, a greater sense of personal strength and spiritual development. There appears to be a basic paradox apprehended by trauma survivors who report these aspects of posttraumatic growth: Their losses have produced valuable gains…

Individuals who face trauma may be more likely to become cognitively engaged with fundamental existential questions about death and the purpose of life. A commonly reported change is for the individual to value the smaller things in life more and also to consider important changes in the religious, spiritual and existential components of philosophies of life…“

Reflecting on my own experiences from Desert Storm, where I was shot-down, captured and tortured, I believe I’ve come out of the experience stronger and more resilient.

It seems many philosophical and religious themes include the idea of strengthening through adversity. Famously Admiral Jim Stockdale advocated the stoicism of Roman philosopher Epictetus, which helped him endure years of captivity in Hanoi. This is not to say that trauma and stress are desirable, Tedeschi and Calhoun are quick to point out that “For most trauma survivors, posttraumatic growth and distress will coexist, and the growth emerges from the struggle with coping, not from the trauma itself.”

BA