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“I THINK I must be crazy,” said Julia, an Iraq war veteran. “At a welcome-home ceremony, I didn’t know they were going to fire cannons. I was holding a bottle of champagne, and when they fired and fired and fired, I went nuts. I hurled the bottle at a tree, stuck my head between my knees, and shook until it stopped. Crazy, right?”

As a psychologist, I know most people will end their sessions by saying something like “Crazy, right?” But veterans of the Iraq and Afghanistan wars say this with a particularly disturbing intensity. Their degree of anguish and alienation from loved ones makes it especially hard to persuade them that the word “crazy” does not apply to them.

Consider Julia, who had spent a year in Baghdad, hearing explosions every day. Since her return, not one night had brought restful sleep. A sociable person, Julia was stunned to feel full of rage “at friends and family who had done nothing” – and at herself. She had been seized by the impulse to crash her car into a mountain: the only way to avert this was to dig her fingernails into her palms until they bled and yank hanks of hair from her scalp.

“Iraq was terrifying because I had no idea how to explain my feelings,” said Julia. “My assignment was pat-down searches of Iraqis, who might have been friends or been wearing explosives. If a search had located a bomb, I’d have been dead. It was rough when this larger-than-life soldier we all loved died from a roadside bomb. But I keep thinking how many thousands have gone through this and been fine. Not one soldier in Iraq told me they were scared, angry or crazy. They were sad when the big guy died, but nobody lost control.”

The thought “maybe if I kill myself, I’ll stop feeling so angry and will get some sleep” ran through Julia’s mind constantly. She thought of therapy but feared that if she saw anyone in the military they could discharge her, ruining her plans to retire on an army pension. Eventually Julia visited a civilian psychologist, who encouraged her to let her guard down. But she clung to numbness, believing it protected others from her irrational anger. She also thought: “If I’m redeployed, I can’t have my feelings exploding all the time.”

The military ethos discourages soldiers from talking about their fear, frustration, helplessness and uncertainty. Julia once spoke to another soldier about her fears that someone on whom she was doing pat searches could kill them. He replied: “Aw, no, they won’t!” Never again did she say anything that wasn’t gung-ho about work. No officer said negative feelings were normal; sometimes someone would say that any soldiers who felt depressed or anxious should tell their leader, and be passed on to a chaplain or counsellor. But the message was clear: needing help was unsoldierly. For men, it was unmanly; for women, it proved they should not be soldiers.

For the most part, the military offers little help for the emotional carnage of war. Its top priority is to produce soldiers who, above all, continue to function. They often hand out anti-depressants to blunt emotions that only resurface later. In the second world war, a soldier who broke down after seeing a buddy blown to bits was usually sent far from combat and given time to recuperate. More recently, the military switched to the PIE approach – proximity, immediacy and expectation -claiming it was to protect soldiers from “survivor guilt”. This means soldiers who have been overwhelmed by war’s horrors are kept near combat zones, sent back immediately, perhaps after a few days’ rest, with the expectation conveyed that they will soon be fine. Of course, soldiers sent back to the front are likely to see more comrades die, increasing the chances of suffering from survivor guilt.

Transition times can also be excruciating. Ray, a veteran who had been holed up near Kabul for months, recalled how in preparing for leave, he was called to a meeting where soldiers were told not to hit their wives. “That’s all the advice we got,” Ray said.

Back in his home town, people asked: “What’s it like there?” Ray was dumbfounded. How could he possibly convey what he’d seen to the citizens of this peaceful Midwestern place: the constant, battering uncertainty about friends and enemies, the life-and-death stakes of a wrong guess? Even if he could, should he? “Soldiers have a duty to protect folks back home by fighting wars abroad but also to protect them from our emotional nightmares,” he said. People felt Ray was weird because he wouldn’t talk about the war. Chasms grew. His best friend stopped calling. Family interactions were awkward.

Julia stopped therapy because she wanted to remain numb and because she needed to feel like her old self. “I’ve always been independent, and I thought I didn’t need a shrink, I could do this myself,” she recalled. But do what? Where to begin?

Then a college professor invited her to speak to her class again. On leave the previous year, she had spouted “the army’s book, what they want you to say”. This year was different. Trying to stay calm, she talked of what she had seen, the sleep that brought no rest, the numbness. She described the self-hatred she felt watching a character in a TV series about the war handle a situation better than she had. A student asked why she was so hard on herself and why she liked staying numb.

Struck by the student’s compassion and directness, Julia told the truth: “I feel like if I kill myself, maybe I can get some sleep.” That night, she slept soundly for the first time in months. Why? Someone, a stranger, had wanted to understand, and others to listen. It was easier to talk to them than to loved ones she felt more of a responsibility to protect.

In our culture, we send traumatised people behind the closed doors of therapists to seek help we presume only experts can give. And, after all, who really wants to hear about the emotional and physical carnage of war?

Is this healthy for any of us? Good therapy helps, but the truth is our soldiers have to meet impossible standards which demand they conceal their real, human feelings. Being sent to a therapist reinforces the message that soldiers are crazy, as does diagnosing them with post-traumatic stress disorder, classified as a mental illness. And experience from other wars shows therapy and/or drugs help some people somewhat, but for many the life-destroying suffering persists.

So what should we do? We can tell veterans they’re not mentally ill to feel rage, despair, and self-hate, for if those feelings in response to constant danger, ambiguity, and changing justifications of the war are pathological, then what would be a healthy response?

In his book What Really Matters, Harvard psychiatrist Arthur Kleinman proposes we ask how any human could not have such feelings. He and professionals like me believe that calling the devastating effects of war “mental illness” is to make the big mistake of thinking the problem springs from individual psyches. It is absurd to say everyone traumatised by war is mentally ill. The veterans want what we all want: life, safety and tranquillity.

If we ignore the veterans’ numbness and silence, colluding when they try to protect us, who then will protect them? Research shows social support is often the most important factor in healing. Better, it heals without the shame of being considered mentally ill. We need to create opportunities for interaction to show soldiers they are more than the sum of their reactions to war, and help them recover who they were and who they still could be.

We can also offer veterans a chance to speak their truth, and tell them that, for as long as they want to talk, we will listen. We can say that we would have reacted the same way if we had been there. Being open to hearing the horrors and shame that torment them is to take away some of the poison. In reaching out, we learn and teach others the full measure of the devastation wrought by war and make it less likely that, as a nation, we will go to war quickly and unthinkingly again.

“Being prepared to listen to soldiers’ horror and shame takes away some of the poison”

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