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"On Killing II: The Psychological Cost of Learning to Kill"

Conclusion: An Application to PTSD Resulting from Killing

Thus we have seen that there is a powerful resistance to killing in most healthy human beings. We have also seen that military and law enforcement organizations around the world have initiated a powerful conditioning process, through military combat training, that has enabled combatants to bypass this resistance. An extraordinarily high firing rate resulted from this process among US troops in Vietnam, British troops in the Falklands, and among modern US law enforcement officers.

But conditioning which overrides such a powerful, innate resistance has enormous potential for psychological backlash. It has been noted that every warrior society has a “purification ritual” to help the returning warrior deal with his “blood guilt” and to reassure him that what he did in combat was “good”. In primitive tribes this generally involves ritual bathing, ritual separation (which serves as a cooling-off and “group therapy” session), and a ceremony embracing the veteran back into the tribe. Modern Western rituals traditionally involve long separation while marching or sailing home, parades, monuments, and the unconditional acceptance of society and family. As was noted previously, after Vietnam this purification ritual was turned on its head, and America paid a tragic price, with anywhere from 0.5 to 1.5 million cases of PTSD occurring as a result of our conduct of that war.

One vital, age old aspect of this "purification ritual", can and has been, reintroduced since Vietnam and that is the "debriefing," conducted every night around the campfire. The introduction of 24-hour combat for months on end in World War I created an environment in which it became impossible for the soldier to perpetuate this ancient, nightly ritual. Throughout the 20th century the opportunity to conduct a daily processing of combat experiences disappeared from the battlefield. The group critical incident debriefing is not a new occurrence on the battlefield. The absence of this daily debriefing is what is new, and now we are reintroducing this ancient process, with a degree of systematic, scientific expertise that has never occurred before.

Today, there is a moral, medical, and legal obligation to conduct these group debriefings. These debriefings must include all of the individuals who were involved in the critical incident, or, if that is not possible, individuals who were involved in similar incidents. Any organization that sends individuals in harms way, and especially any organization that calls upon humans to participate in the psychologically toxic realm of interpersonal aggression (which is, perhaps, the “universal human phobia”), and does not subsequently conduct a critical incident debriefing is morally, medically, and legally negligent.

Furthermore, there must be an environment wherein there are no “secrets” to be kept, since the perpetrators may well be “only as sick as their secrets.” That means, to the utmost of our ability, we create an environment of transparency and accountability in which no atrocities or criminal acts can occur, since these are the ultimate “secrets” which often cannot be confessed and must be kept at all costs. Col. Greg Belenke, a psychiatrist and head of one of the combat stress teams in the Gulf War, has definitively stated that atrocities and criminal acts are one of the surest paths to PTSD. PTSD can be thought of as “the gift that keeps on giving,” since it impacts not just the perpetrators, but also their spouses and their children in the decades to come (Belenke, 1996).

Rachel MacNair, in her research, has found that: "The item, 'There were certain things I did in the military I can't tell anybody,' was a strong indicator of the perpetration groups in just about every way I looked at it. When I compared those who were directly involved in the killing of civilians or prisoners with those who witnessed that but were not directly involved, yet did kill in other contexts (presumably more in line with traditional combat), the two items that differentiated were that one and nightmares" (R.M. MacNair, personal communication, June 15, 2000).

This means that atrocities, the intentional killing of civilians and prisoners, must be systematically rooted out from our way of war, for the price of these acts is far, far too high to let them be tolerated even to the slightest, smallest degree. This means that we enter into an era of transparency and accountability in all aspects of our law enforcement, peacekeeping, and combat operations. This also says something about that those who are called upon by their society to “go in harm’s way,” to use deadly force, and to contend with interpersonal human aggression. These individuals require psychological support just as surely as they require logistical, communications, and medical support. Thus, as our society enters into the Post-Cold War era, the fields of psychiatry and psychology have much to contribute to the continuing evolution of combat, and to the evolution of our civilization.

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