Questioning PTSD

[rukawa]

A really great article on PTSD:

https://www.vanityfair.com/news/2015/05/ptsd-war-home-sebastian-junger

 

From the article:

They return from wars that are safer than those their fathers and grandfathers fought, and yet far greater numbers of them wind up alienated and depressed. This is true even for people who didn’t experience combat....Ethnographic studies on hunter-gatherer societies rarely turn up evidence of chronic PTSD among their warriors, for example, and oral histories of Native American warfare consistently fail to mention psychological trauma....Either way, it makes one wonder exactly what it is about modern society that is so mortally dispiriting to come home to.

 

Another article questioning PTSD:

https://www.wired.com/2012/03/the-ptsd-trap/

[EricSchleien]

Snowflakes

[JRM]

There was an episode of Black Mirror on Netflix that had an interesting take on this.  Not sure if it is true or not.  Basically they stated that in older wars more people died from disease, mal-nutrition, and infection rather than actual combat.  In the revolutionary war times people many times fired over the heads of their enemies, not actually trying to kill their opponent.  From the Vietnam onward the mortality rate on a per soldier basis has increased (they state).  A single drone operator or sniper may be responsible for killing dozens of people without "facing combat". 

 

That said, I have relatives who have fought in the Battle of the Bulge (WW2) and later in the Korean War.  They have very gruesome stories to tell, but I think they tended to suppress their bad memories.  If they had PTSD they didn't talk about it. 

 

 

[EricSchleien]

There was an episode of Black Mirror on Netflix that had an interesting take on this.  Not sure if it is true or not.  Basically they stated that in older wars more people died from disease, mal-nutrition, and infection rather than actual combat.  In the revolutionary war times people many times fired over the heads of their enemies, not actually trying to kill their opponent.  From the Vietnam onward the mortality rate on a per soldier basis has increased (they state).  A single drone operator or sniper may be responsible for killing dozens of people without "facing combat". 

 

That said, I have relatives who have fought in the Battle of the Bulge (WW2) and later in the Korean War.  They have very gruesome stories to tell, but I think they tended to suppress their bad memories.  If they had PTSD they didn't talk about it.

 

From my experience, completely anecdotal and non-scientific, older generations processed this differently. I have found them on average less sensitive and "triggered" by horrible events.

[Cigarbutt]

Very controversial and delicate topic.

Very real disease but diagnostic criteria are vague and an area where respectful discussions can occur despite the sensitivity in order to optimize ressource allocation/utilization.

 

First-hand experience with war and its consequences may help to treat the topic gently.

Second-hand descriptions may offer a reasonable alternative.

Example:

https://www.amazon.com/Waiting-First-Light-Ongoing-Battle/dp/0345814436/ref=sr_1_1?ie=UTF8&qid=1523822774&sr=8-1&keywords=romeo+dallaire+memoirs

 

With the above in mind, have to evaluate how poor incentives may aggravate the situation.

 

There is a fair amount of work showing that a significant amount of people have pre-existing pathology and may eventually have manifested symptoms compatible with the label of PTSD, even without war experience.

 

Also, with the newer threshold for diagnosis, some feel that it is acceptable to label someone with PTSD even if one was unconscious during the traumatic episode... Some therapists have even suggested that the disease may be "contagious" through hearing the stories...

 

A few years ago, in my area, two prison guards were killed by a biker gang as a way to intimidate the judicial system. Prison guards who were directly involved were also considered "victims" and received help. However, there was a very large contemporary request by a large number of prison guards, all over the province, who then applied for long term disability (supported by medical certificates) related to PTSD after viewing on TV that a prison guard they did not know had been killed. Those claims were denied and I understand that most of these prison guards did not maintain their disability status.

 

So, tough topic and hard to understand but sometimes by trying to help, one may aggravate the situation.

[LR1400]

There was an episode of Black Mirror on Netflix that had an interesting take on this.  Not sure if it is true or not.  Basically they stated that in older wars more people died from disease, mal-nutrition, and infection rather than actual combat.  In the revolutionary war times people many times fired over the heads of their enemies, not actually trying to kill their opponent.  From the Vietnam onward the mortality rate on a per soldier basis has increased (they state).  A single drone operator or sniper may be responsible for killing dozens of people without "facing combat". 

 

That said, I have relatives who have fought in the Battle of the Bulge (WW2) and later in the Korean War.  They have very gruesome stories to tell, but I think they tended to suppress their bad memories.  If they had PTSD they didn't talk about it.

 

They had ptsd, they just called it shell shocked and there was more negative stigma attached to talking about feelings. WW 2 was beyond brutal.

 

Know former tier one special mission unit guys, screened for “emotional” stability who know they have it but really really just say it’s frowned upon to have it.

 

When people are blown up, maimed, etc. and you do the same to others...well what do you expect. I would say it’s normal. I would agree that past societies that are used to some death, even hunting makes it easier to tolerate.

 

Even the soviets who slaughtered Poles in the great purge killed themselves later.

[LR1400]

https://www.telegraph.co.uk/history/world-war-two/11983763/There-was-no-help-for-PTSD-when-I-left-the-Army-in-1945-but-we-still-dont-do-enough-for-our-veterans-today.html

[LR1400]

https://historyofptsd.wordpress.com/world-war-ii/

[LC]

WW1 was also pretty devastating. I believe that is where the term shellshock originated. The stigma associated with those suffering was also atrocious.

[rukawa]

The question the articles asks is not whether the symptoms of PTSD are real but instead whether they reflect the horrors suffered in war or the difficulty in adjusting to civilian life. A brilliant science fiction novel that explores the same idea is Forever War:

https://en.wikipedia.org/wiki/The_Forever_War

[Cigarbutt]

Recent article from the Canadian Underwriter:

https://www.canadianunderwriter.ca/insurance/traumatized-witnesses-van-attack-make-case-accident-benefits-1004131225/

 

Interesting example of a legal precedent that is having a significant impact on the definition of the threshold necessary to determine a link between an "accident", a mental condition such as PTSD and the compensation related to mental "injuries".

 

Tough topic with scientific and social overtones.

I would say that this evolving issue hasn't been accounted for by the underwriters up to this point.

 

[Jurgis]

https://www.nytimes.com/2018/06/13/magazine/veterans-ptsd-drone-warrior-wounds.html

[Cigarbutt]

https://www.nytimes.com/2018/06/13/magazine/veterans-ptsd-drone-warrior-wounds.html

 

Interesting read as I was analyzing the potential market share of the Da Vinci system (Intuitive Surgical) for robot-assisted procedures and realizing how there is an evolving recognition of "moral injuries". Mind under matter.

[flesh]

I wonder if the net psychic loss due to the actual/perceived purposelessness of recent wars in the combatants, plus their close ones, and society versus past wars affects the problem.

 

Or, if your friend is blown up in front of you as part of an eventual end to jewish concentration camps and you're successful in the end... and the world agrees... vs you have no idea why you're there and when you get back everyone wonders what the point was immediately thereafter and more so over time.

 

In one case your a hero, your friend is a hero, everyone's a hero in everyone's eyes for the rest of their lives when they get home. In another, humanities general difficulty with nihilism is magnified and you chance of recovery isn't largely ameliorated.

[Jurgis]

I wonder if the net psychic loss due to the actual/perceived purposelessness of recent wars in the combatants, plus their close ones, and society versus past wars affects the problem.

 

Or, if your friend is blown up in front of you as part of an eventual end to jewish concentration camps and you're successful in the end... and the world agrees... vs you have no idea why you're there and when you get back everyone wonders what the point was immediately thereafter and more so over time.

 

In one case your a hero, your friend is a hero, everyone's a hero in everyone's eyes for the rest of their lives when they get home. In another, humanities general difficulty with nihilism is magnified and you chance of recovery isn't largely ameliorated.

 

Although I agree that WW2 was a war with really clear moral purpose, there were a bunch of past wars that were purposeless too. WW1, for example, seems to have been pretty pointless... although some people might disagree.

 

With WW2 it's interesting how well the defeated nations picked themselves up. Germany, Japan, even Italy. I still think it's amazing that coming out of WW2 a lot of former enemies became mostly friends (minus Soviet camp) and were integrated into global community.