Moving from the Descriptive Effects of War to the Prescriptive Effects of War - Essay Example

Moving From the Descriptive Effects of War to the Prescriptive Effects of War War has many casualties, we all know that. What most of us do not realize is the psychological upheavals war creates. It is easy to predict the success or failure of a war. For example, the Allied powers won in World War 2. However, we have forgotten to analyze the deep mental scarring it has left us. Hence, to put it simply, even though one may say that the descriptive effect of a war is a victory or a loss, the perspective effects of war are always a failure. Let us examine the war with Vietnam. In all aspects, descriptive and prescriptive, the war can be described as a failure. In terms of numbers, approximately sixty thousand were killed, two thousand were captured, and three hundred fifty thousand; mutilated and wounded. (CNN 2013) For many Americans, the Vietnam War is a chapter in history. It is forgotten. However, the soldiers who survived the war and returned to USA, the psychological trauma is real, and it still haunts them. Most of the recruits in the Vietnam War were young men, just out of College. They were sent into an active war zone, with little or no respect for humanity. Those who survived this gruesome war came back to USA and faced great difficulty in adjusting to Civilian Life. (Hochgesang, Lawyer, Stevenson 1999) However, the adjustment problems faced by these soldiers vary from each individual to the other. Some veterans report having regular flashback of the combats they were engaged in, some face alienation from society, others simply fear getting close to anyone in society, sometimes even their families. A lot of these soldiers have alcohol or drug dependencies. Some even contemplate suicide. The psychological effects of the Vietnam War are endless. These psychological issues were defined as ‘Post Traumatic Stress Disorder’(PTSD) in the American Psychiatric Association’s DIAGNOSTIC & STATISTICAL MANUAL III (DSM III) (Suicidewall 2014). Furthermore, PTSD was linked to ‘Survivor’s Guilt’ by The Vietnam Veterans of America (VVA) (Brinson and Treanor 1984) Glover, (1984) says that “the phenomenology and clinical characteristics of survival guilt which can be found in many Vietnam veterans. This conflict, in its most acute presentation, typically resembles an agitated depression. The syndrome is characterized by the veterans frequent dreams of their friends dying in battle, and by their avoidance of interpersonal intimacy because they fear the other party may abandon them or die. The section on treatment recommendations emphasizes the importance for psychotherapists to confront continuously the veterans many self-destructive patterns of behaviour. Psychotherapy should also address any false beliefs the veterans may entertain regarding the nature of their survival.” (Hillel 1984) An example of extreme stress can be found in cases of War veterans returning from active war zones around the world. It is not uncommon for these soldiers to extreme PTSD . The American Psychology Association (APA) describes PTSD, as an “anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident or natural disaster. People with PTSD may relive the event via intrusive memories, flashbacks and nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before that are so intense their lives are disrupted.” (www.apa.org 2014) An important thing to consider while we discuss the Vietnam War is the average age of the soldiers. The average age of the soldiers fighting in World War 2 was twenty-six. However, the average age in the Vietnam War was just nineteen; they were barely out of college. The underlying factors of PTSD in War Veterans was not only the psychological impact of the war, there were other factors that accounted for the onset of PTSD among them. First of all, the Vietnam War was a loss for the US, thus, the soldiers returning from the War were not viewed as heroes, but as losers, and they were made to realize this time and again. Then, it was an extremely violent and bloody war, the enemy was not always known, and many civilian casualties were reported at the hands of the US Military, for which they were severely ostracized both at home and internationally. Many of the returning soldiers were viewed as people with low morals who would kill at the drop of a hat by their local people. There were no readjustment or rehabilitation provided to these soldiers after going through immense psychological trauma. Finally, the time they arrived in the USA, America was undergoing a period of slow economic growth. Thus, jobs were hard to find. They were often the last people to get jobs and the first to get the pink slip in case the company was downsizing. (Brinson and Treanor 1984) As the Medical records on the veterans of the American Civil War between 1860-1865 were digitalized, called ‘Early Indicators of Later Work Levels, Disease, and Death Project’ experts have noticed an higher risk of post war trauma in Civil War Veterans. These include “cardiac, gastrointestinal, and mental diseases throughout their lives of PTSD to date have connected war experiences to the recurrence of mental health problems and physical health problems such as cardiovascular disease and hypertension and gastrointestinal disorders. These studies have not had access to long-term health impacts, since they have been focused on veterans of recent conflicts. Researchers studying the impact of modern conflict participation report that the factors increasing risk of later health issues include age at enlistment, intimate exposure to violence, prisoner of war status and having been wounded.” “In a project partly funded by the National Institutes of Aging, military service files from a total of 15,027 servicemen from 303 companies of the Union Army stored at the United States National Archives were matched to pension files and surgeons reports of multiple health examinations. A total of 43 percent of the men had mental health problems throughout their lives, some of which are today recognized as related to post-traumatic stress disorder (PTSD). Most particularly affected were men who enlisted at ages lesser than 17.” (Hirst n.d) Now one may examine a war that was won, the Persian Gulf War in 1990-1991. The War is a clear victory in descriptive terms for the USA. However, as is in the case of any war, the prescriptive effects are losses: Psychological and social, especially for the soldiers and their families. These soldiers too have displayed symptoms of PTSD, especially survivor’s guilt. Their coping mechanism too has been linked to dependency on drugs and alcohol. (Sinclair 2013). Thus, we can conclude that even though America won the War, the psychological scarring can still be felt amongst these soldiers. In their book, Emotional Aftermath of the Persian Gulf War: Veterans, Families, Communities, and Nations by Robert J. Ursano, Ann E. Norwood say that the symptoms of PTSD among returning soldiers of the Gulf War can be put into two groups. These are: Thoughts that invade their personal space by reliving the traumatic events that took place while they were in combat, and, symptoms of dodging and abnegation. (Ursano and Norwood 1996 p.49) The impact of killing on mental health symptoms in Gulf War veterans by Maguen, et al (2012) “This study examined the impact of killing on posttraumatic stress symptomatology (PTSS), depression, and alcohol use among 317 U.S. Gulf War veterans. Participants were obtained via a national registry of Gulf War veterans and were mailed a survey assessing deployment experiences and post deployment mental health. Overall, 11% of veterans reported killing during their deployment. Those who reported killing were more likely to be younger and male than those who did not kill. After controlling for perceived danger, exposure to death and dying, and witnessing killing of fellow soldiers, killing was a significant predictor of PTSS, frequency and quantity of alcohol use, and problem alcohol use. Military personnel returning from modern deployments are at risk of adverse mental health symptoms related to killing in war. Post deployment mental health assessment and treatment should address reactions to killing in order to optimize readjustment”. (Maguen, 2012) This study shows us the demographics associated with PTSD and PTSS. The psychological effects of War are not only experienced by the soldiers, but, their families have to go through a similar ordeal as well. Knowing their loved ones are at War, for their country, for reasons only the Government has outlined, they spend their time praying for the well-being of their loved ones. The psychological trauma that is experienced by these families, if the soldier is killed during battle is inexplicable. If the soldier survives and returns home, it’s still not the same for the families. (Sherbourne, Gaillot, Hansell & Ritschard, 2011) Resilience is an important trait in reversing the after effects of a combat situation, especially among soldiers. Resilience is further bolstered by the presence of spirituality, which motivates resilience. Let us examine Resilience and Spirituality in a bit more detail. Spirituality and Resilience: The American Psychological Association reports that “resilience” is the process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant sources of stress—such as family and relationship problems, serious health problems, or workplace and financial stressors. (http://apa.org 2014). In layman terms, resilience is getting back from a tough situation. We exhibit resilience almost daily in our routine lives, when we do not let an adverse situation get the better of us, and bounce back to face the problem at hand, and eventually solve it. Resilience is not about solving the problem; it is about facing the problem with the belief that it can be solved. An example of resilience can be cited as the determination of the American public to rebuild their lives, and the nation after the attacks of September 11. Resilience is not the absence of fear and stress. Rather, it is the belief and capacity of a person to handle that stress. In fact, in order to be resilient, one has to face a lot of stress initially. We use the metaphor of “bounce back” to describe resilience. (Dees. & Huckabee 2011) In her book Unbroken, Hillenbrand tells us the story about a young lieutenant, Louis Zamperini who despite facing tremendous odds bounced back in the time of World War 2 through his sheer resilience and mental strength. (Hillenbrand, 2010) The War in Kosovo in 1998/99 left a devastating effect on the minds of the public. It was a bloody war, one which caught even the civilians unaware. The recent war and unexpected and untimely losses of lives led to substance abuse amongst the young people in Kosovo. Absence of proper mental health care professionals meant that substance abuse was one of the best options for the locals to get over the war. (Garrett & Landau, 2006 p. 65) Role of Spirituality and Professionals in Resilience: Webster defines Spirituality as “the quality or state of being concerned with religion or religious matters.” Hence, we can say that being spiritual is having extreme faith in one’s religion. It is the belief that salvation can be achieved through being religious. Christians believe that being spiritual is to have a knowledge about God, and knowledge about ourselves. According to Paul, in the Bible, Knowing God is to be “transformed by the renewing of minds, so that may discern what is the will of God.” (Romans 12:2) He says that doing this is our spiritual worship (Romans 12:1). Knowing ourselves, according to Christians means to know our Soul. We can do so by asking ourselves a few simple questions: What is important to us? Can we sense God’s presence in amongst us, Are we able to identify any feelings of restless or irritability in our daily routines? Brady defines “Spiritual well-being is conceptualized as reflecting ‘a sense of meaning in one’s life, harmony, peacefulness’ and is strongly positively related to quality of life” (Sherbourne, Gaillot, Hansell & Ritschard. 2011) The Bible is rife with examples of people with extraordinary resilience. Although the word ‘resilience’ itself does not appear in the Bible, the concept of being strong and having complete faith in God does. In fact, the Bible equates resilience to having faith. Some examples of ‘being strong’ in the Bible are: Psalm 31:24 So be strong and courageous, all you who put your hope in the Lord! (Bible Study Tools n.d) It motivates a person in time of adversity. It is a call for help, with inherent deep beliefs. One realizes the great pain he is, till he puts his complete faith in God, and he realizes God is with him and His strength and courage is with him too and thus, he urges others to show strong faith in God as well. 1 Corinthians 15:58 So, my dear brothers and sisters, be strong and immovable. Always work enthusiastically for the Lord, for you know that nothing you do for the Lord is ever useless. (Bible Study Tools n.d) This is a call by a person of extreme faith to motivate others around him to never give up hope, to be strong in belief and determined in faith of God, He goes on to say that God always rewards resilience and determination, because He has made us that way. Romans 1:11 For I long to visit you so I can bring you some spiritual gift that will help you grow strong in the Lord. (Bible Study Tools n.d) This is a doctrine of Paul, who motivates people in the belief of God along his travels. Ephesians 6:10 A final word: Be strong in the Lord and in his mighty power. (Bible Study Tools n.d) Have complete faith in God, and believe that He is the supreme power and that He can cure all of your troubles. Spiritual resilience is largely based on the theological concept of morals, or good and bad. A person of faith generally conforms to the rules laid down in religion, and judges aspects of life according to his learning of these books. (Titus, 2006 p.81) Any war, manmade calamities, produces ruinous effects on the mental health of communities, that is proven by many studies that show that “conflict situations cause more mortality and disability than any major disease” (Avdibegović, Hasanović, Selimbašić, Pajević & Sinanović , 2008) More elaborately, moral injury can been defined as “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations” (Drescher, Foy, Kelly, Leshner, Schutz, & Litz, 2009 p.8). Spirituality helps repair these moral injuries. There is a sense of hope, in the belief of the might of God. That God will restore the wounds inflicted by trauma. For many of us, any traumatic event such as a War or a Terrorist Attack not only challenges our emotional and physical strengths, it is extremely taxing on our spiritual beliefs as well. As in the case of any religious person, events such as War can do either of two things, either it can make you turn to your religion, and look for answers through God. Or, it can cause you to express doubts and questions. These questions are normally expressions of doubt, such as ‘Why did God do this?’ ‘Is this Fair?’ ‘Why me/us?’ In such difficult times, we intend to find the meaning of what has transpired. This is where experts believe, faith comes in. The main elements of any religion can be outlined as “Trust, hope and strength.” A lot of us turn to prayer to try and get through these feelings of uncertainty and doubt. Experts believe in times like these, it is important to be busy, to find things that our good for the mind, things that help us draw inspiration from our religion. Temples, Churches, Mosques or Synagogues can help as support systems for us by providing the hope for a better tomorrow and that the worst shall soon end. Normally, all places of worship have a Minister, Rabbi, Imam or a Priest. These people help us address our doubts by citing examples in religious texts that help annul a lot of our concerns. Moreover, it provides a deeper connection with God and helps us restore faith to ourselves and those around us. Spending time at our place of worship with fellow community people helps us quell a lot of our fears. Moreover, it helps to bring Community closer by participation, which can come in handy in cases of Emergency. (Ball State Counseling Center 2014) In times of trauma, one often neglects the thing he should have been doing first. It is very easy to get lost in one’s troubles and abandon hope. This is true especially in times of War. This is where professionals can help soldiers maintain focus. During times of War, the US has traditionally given people access to Trauma Centers, where apart from physical trauma; one can seek help for mental turmoil as well. These Trauma Centers employ professionals in the field of psychology to help build mental confidence amongst people. They help people through psychotherapy. Some of the major approaches to psychotherapy include (Cherry n.d) Psychoanalytic: It is the method of therapy designed to delve into the patients past, his experiences and feelings, and determine his subconscious needs and desires. (Cherry n.d) Cognitive-behavioral: This is a type of therapy that uses perception and knowledge of behavioral techniques to change negative thoughts and dysfunctional behaviors. (Cherry n.d) Humanistic: This form of therapy focuses on helping people improve their potential and be more efficient and effective in the work they do.. (Cherry n.d) Psychotherapy is increasing in popularity, particularly in USA, with it being look upon as a distinct profession now. However, the role of a psychotherapist can sometimes be fulfilled by non professionals as well. Such people may be Voluntary Social Workers and/or close and dear ones. In order to combat this growing PTSD among soldiers returning from combat duties, the US Army has taken an initiative called” Comprehensive Soldier Fitness program” as it looks to combat the stress experienced in a soldiers life due to combat, with the help of leading psychologists in the USA. The idea behind the soldier fitness program is that the response to strong adversity, like combat, is bell shaped, says Martin E.P. Seligman, PhD, director of the Positive Psychology Center at the University of Pennsylvania. "We dont assume people can shoot when they come into the Army, so we teach them how to load weapons and how to aim," says Brig. Gen. Rhonda Cornum, PhD, MD, director of the Comprehensive Soldier Fitness program. "We need to attend to psychological fitness the same way we do physical performance." (Http://www.apa.org. 2014) The program believes that if the soldiers can learn how to deal with the psychological difficulties of war, they shall be more effective in avoiding depression or dependency on drugs or alcohol once they return from active duty. Moreover, they shall be able to value their friends and family and not have suicidal tendencies. The Vietnam War can clearly be defined as a failure both in descriptive and prescriptive terms. As mentioned earlier, the US army has taken an initiative called “Comprehensive Soldier and Family Fitness, or CSF2, is designed to build resilience and enhance performance of the Army family, which is comprised of Soldiers, their families, and Army civilians. CSF2 does this by providing hands-on training and self-development tools so that members of the Army Family are better able to cope with adversity, perform better in stressful situations, and thrive in life.” (Feeney 2014). This program is aimed at helping both the soldier and his family. As we can infer, the events of War are as much traumatic to the family as it is to the soldiers. CFS2 defines resilience as the tenacity to ‘bounce back’ from an unfavorable situation and face adverse situations positively. Several US Army soldiers have thus far benefitted from this program, including Lt. Col. Hunter Marshall, commander of the 3-25th Aviation Regiment, 25th Infantry Division. To quote Col. Marshall, "Taking the executive training, I also could see the personal value in it for me as a commander. The Energy Management skill taught me to identify where to focus my energy when I am juggling several tasks at once. The Avoid Thinking Traps skill helped me to understand other peoples thinking process so that I can communicate with them more effectively," (Feeney 2014) As Col. Marshall said, the training has been useful to him, both personally as well as in man management, he can now relate to the thinking process of his unit. To put things into perspective, we can infer that the after effects of War leave huge psychological scarring, for all those involved. There is a popular saying ‘To the Victor go the Spoils’. However, if we leave out the quantifiable win or loss of war, the qualitative effect of War is that there are no spoils. It’s all losses. The soldiers’ trauma, those of their families and the public at large may be different in nature. However, there is no denying the fact that these trauma stem from a common source. Hence, countries, societies and Governments should take into account the psychological factors before deciding to engage in War. In order to avoid war or terrorist strikes, we need to examine what are the causes of these events, and how some ways have been successful in avoiding war and others not. For example, the “War on Terrorism” has only been focused at the attacks on September 11th, when an organization of radicals and extremists belonging to a geographical location stretching from North Africa to Southeast Asia, hijacked the Nation on the day. If only we can develop a better understanding of the culture, history and eco-social conditions of that part of the world, and help bring about changes without combat, can we avoid this threat completely? . Thus, if we are genuinely interested in avoiding war and it’s after effects, we must first analyze the conditions that perpetrate such extreme events. War is not a solution. We must avoid it by tactful diplomacy and continuous dialogue with a perceived threat. As the famous comedian George Carlin once said, “Fighting for peace is like screwing for virginity.” It does not make sense. If War is thrust upon us, we must make sure that sufficient measures are taken to ensure that the psychological scarring is repaired before it gets out of control. They can do this with the help of professionals or promoting Spirituality in Communal well being. Spirituality too plays a crucial role in nurturing resilience. References Avdibegović E, Hasanović M, Selimbašić Z, Pajević I &Sinanović (2008) Mental Health Care of Psycho traumatized Persons In Post-War Bosnia And Herzegovina -Experiences From Tuzla Canton. Psychiatr Danub Brinson and Treanor (1984) The Official Voice of Vietnam Veterans of America, Inc. ® March/April 2005 publication. Brady, Marianne J., Amy H. Peterman, George Fitchett, May Mo, and David Cella (1999.), A Case for Including Spirituality in Quality of Life Measurement in Oncology, Psycho-Oncology, Bible Study Tools (For citations from the Bible) available at http://biblestudytools.com Ball State Counselling Centre (2014) Ways to Remain Resilient retrieved on February 27 2014 available at https://cms.bsu.edu/campuslife/counselingcenter/newsfooteritems/dealingwithstressdepressionanxietysuicideandtraumaticevents/traumaticevents/remainingresilientintimesofwar/stepsforremainingresilientinwartimes Cherry K (n.d) The History, Approaches and Criticisms of Psychotherapy retrieved on February 28 2014, available at http://psychology.about.com/od/psychotherapy/a/what-is-psychotherapy.htm CNN (2013) Vietnam War Fast Facts CNN Library 2013. Retrieved on February 27 2014, available at http://edition.cnn.com/2013/07/01/world/vietnam-war-fast-facts/ Dees,. & Huckabee, (2011). Resilient warriors. San Diego, Calif.: Creative Team Pub. Drescher, K. D., Foy, D. W., Kelly, C., Leshner, A., Schutz, K., & Litz, B. (2011). An exploration of the viability and usefulness of the construct of moral injury in war veterans. Feeney,. (2014). Comprehensive soldier and family fitness expands resilience training to army leaders | article | the United States army. [online] Retrieved from: http://www.army.mil/article/113208 [Accessed: 27 Jan 2014]. Garrett & Landau, (2006) Family motivation to change: A major factor in engaging alcoholics in treatment. Alcohol Treatment Quarterly, Hirst (n.d) The Irritable Heart Increased Risk of Physical and Psychological Effects of Trauma in Civil War Vets (About.com Psychology) retrieved on February 27 2014 available at http://psychology.about.com/od/ptsd/a/irritableheart.htm Hillenbrand, (2010). Unbroken. New York: Random House. Hochgesang, Lawyer, Stevenson (1999) The Psychological Effects of the Vietnam War, EDGE, retrieved on February 27 2014, available at http://www.stanford.edu/class/e297c/war_peace/media/hpsych.html Hillel (1984) Survival Guilt and the Vietnam Veteran. [Article] Journal of Nervous & Mental Disease. 172(7):393-397, July 1984. Williams & Wilkins 1984. Retrieved on February 27 2014 available at http://ovidsp.tx.ovid.com/sp3.11.0a/ovidweb.cgi?T=JS&PAGE=fulltext&D=ovft&AN=00005053-198407000-00003&NEWS=N&CSC=Y&CHANNEL=PubMed http://www.apa.org. (2014). Strong in mind and body. [Online] Retrieved from: http://apa.org/monitor/2009/12/army-program.aspx [Accessed: 27 Jan 2014]. Maugen et al (2012), APA PsycINFO Database Record, The impact of killing on mental health symptoms in Gulf War veterans. Retrieved on February 28 2014, available at http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/a0019897 Sherbourne, Gaillot Hansell, L. & Ritschard. (2011). 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