Treating the trauma of war – fairly

In relabeling cases of PTSD as 'personality disorder,' the US military avoids paying for treatment.

from the August 20, 2007 edition

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The switch in terms from trauma to hysteria (during World War I) or PTSD to personality disorder (today) is far from trivial. Rather, the new labels allow the government and society at large to do two things: 1) attribute symptoms after serving to individual psycho-pathology; and 2) disown the problem of the former soldiers' suffering. We needn't question the system that sends young people to war – merely the stability of those who bear the emotional brunt of battle.

Politicians have a vested interest in sidestepping the high price soldiers pay for their service. But we know better, and at the very least owe them appropriate medical and psychological care and the acknowledgment of their wounds.

Better screening at the enlistment and training stages is needed, both to forestall retroactive diagnoses and to identify soldiers with personality disorders that could interfere with their duties. (This debate has arisen after recruitment standards have been lowered with regard to mental health and criminal records to fill quotas.)

Better preparation prior to deployment would also help. The National Guard has seen higher rates of PTSD than the Marines. This may suggest that the more extensive training specific to combat received by marines helps them tolerate potentially traumatic situations.

Another important development would be a cultural shift within the military that both recognizes and destigmatizes the need for psychiatric care. This way soldiers and veterans would not be afraid to seek help in a timely manner – or be punished for having psychological complaints.

Finally, we as a nation need to recognize that our actions have consequences for those who assert them – and to remind our leaders before there's any commitment of troops.

Judith D. Schwartz is writing a novel set in Freud's Vienna.

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