Our Sickening Rush to See PTSD – and What It Costs Vets

When Iraq-war veteran Benjamin Colton Barnes shot park ranger Margaret Anderson dead last week, the speculation started almost as soon as the gun reports faded: Barnes must have PTSD. I first saw this speculation on Twitter, where I suggested it was a tad early to speculate, since police were still trying to track Barnes down in the mountains. They later found him dead; he had died of exposure. And as Alex Horton explains at his blog at the VA, Barnes’ crime and his troubles had little to do with his military service, and our collective rush to attribute the crime to PTSD made two enormous but horribly common mistakes: It indulged in a reflexive diagnosis of PTSD for any mental or behavioral problem in any vet; and it erroneously assumed PTSD led frequently to violent behavior.

Here’s Horton on Barnes:

Within hours of the Rainier shooting, journalists and writers clamored to mention Barnes’ war record, combat stress, and even his duty station in a dizzying effort to find a connection:

Ex-soldier in Mount Rainier killing stationed at deeply troubled base

Mt. Rainier killing sparks concern for war veterans

PTSD Help Available for Local War Vets: Park Ranger Slaying Suggests Link to War Stress

Washington’s Mount Rainier Gunman Illustrates Problem of PTSD Among Our Veterans

The Killing of a Park Ranger on Mount Rainer Reminds Us to Help Returning Soldiers

The problem? It wasn’t true.

As more information became available on Barnes, it grew clear that his troubles had little to do with his service in Iraq or his assignment at Joint Base Lewis-McChord. According to The Seattle Times, Barnes was apparently disturbed before he entered the Army—having been expelled from school as a teenager. Additionally, military records show Barnes served in a headquarters communications job in Iraq. A spokesman at Lewis-McChord told the Times there was no record of Barnes having received a Combat Action Badge, indicating he probably never came under fire in Iraq.

While violence is undoubtedly a potential consequence of war-related trauma, highly publicized crimes by active duty members and Veterans cast the overwhelming majority of law abiding Vets in a horrifying—and typically unfair—light. As one Army officer pointed out recently, sensational stories devoid of context (like those about Barnes) inhibit the ability for people to assess likelihood and frequency in a given population. He cites the availability heuristic, which says people “predict the frequency of an event, or a proportion within a population, based on how easily an example can be brought to mind.”

I’m going to let Horton take the baton here, but before doing so, want to  note or reinforce two things:

Our culture’s obsession with PTSD, our reflexive painting of all combat vets as probably ruined by combat, is based on error and misconceptions —  and cruelly unfair to the veterans we think we’re helping by viewing as sick. I wrote on this at length in a feature in Scientific American (subscription required; free PDF) — a feature I had great trouble selling to mainstream media, precisely because it challenges so many of our assumptions and misconceptions about soldiers, war, and mental illness. Horton expands on this in light of the Rainier shooting; do read his full account as well.

With tens of thousands of soldiers returning to the US from Iraq and Afghanistan, Americans need to ask themselves why they so desperately want to see veterans as damaged goods. I think partly it’s out of a weird logic — and some guilt — that because war is hell (and make no mistake, it is), it must plaint within every soldier a devil. It does not.  The two great wonders of war are 1) it is unimaginably horrible and 2) most soldiers emerge from it not merely okay, but in the long run, better.

Consider, for instance, the 1990 study, the National Vietnam Veterans’ Readjustment Study (NVVRS), that established the rates of PTSD in Vietnam veterans. A 2006 updating by some of the main authors, published in Science, revised the numbers on Vietnam veterans — very few of whom got any treatment for years and years after the event — at about 18% lifetime (in other words, at any time during their lives) and 9.1% in 1988, when the study was done. (Despite that, the press frequently reports the earlier, erroneously high values of 16% in 1988 and 31% lifetime.) Other analyses of the same data, with different assumptions and also published in Science, found about half those rates.

Every single one of those who truly suffer PTSD should get excellent treatment; unfortunately, as my story explains, they’re not getting it from the VA, for a number of reasons.

But consider also another finding by the same NVVRS study: almost 75% of the Vietnam veterans soldiers in that study said, 15 years after the war, that it had eventually made them better, stronger, more successful, and happier people. War is hell. But the norm, barring serious physical injury, is not to be destroyed by it. The norm is to come out of it stronger, and a better citizen. They are, for instance, incarcerated at half the rate of non-vets, according to Horton.

Yet our reflex is to assume otherwise — and to assume, when a vet has or makes trouble, that it is due to the war. Sometimes it is. More often it’s not. But when we assume all vets are war-damaged, we short those who aren’t — and by encouraging all to consider themselves sick, we sicken them through our very assumptions. This is an issue that’s not going to go away. We sent these people to war. We should do better by them. Assuming they’re damaged goods is not the way to do them right.

I’ll let Horton finish:

[W]e must step out of the feedback loop that both feeds and informs the stereotype of the broken, mentally unstable Vet. The damaging caricature proved to be difficult for Vietnam Vets to overcome. And with a new generation coming home from Iraq and Afghanistan, history will repeat itself until we take a moment and realize that faulty assumptions are dangerous and that anecdotal, sensationalist conclusions are designed to help sell newspapers and generate hits rather than responsibly inform.

…

The rush to connect Barnes’ wartime service to his horrific crime makes for good drama but bad journalism. There are serious mental health consequences that stem from serving in the line of fire, but we do a disservice to those who suffer from those problems—as well as those who do not. Our communities need the experience and skills Veterans bring now more than ever before. But before that happens, we must chase away the lurid cloud of stereotypes and conjecture that hang over Veterans as they try to find their way after war.

Thanks to petulantskeptic for the heads-up on this.

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Image courtsey VAntagePoint.