Psychological problems and stress faced by soldiers who operate in asymmetric warfare environments: experiences in the field.
This article deals with the problems of anxiety, stress (1) and psychological discomfort that can affect soldiers sent on asymmetric warfare operations (2).
It is based on secondary analysis of the data of two important field researches whose results have recently (2013) been published. The first published in the book Soldiers Without Frontiers: The View from the Ground. Experiences of Asymmetric Warfare (3), collects and analyzes the data obtained from 542 in-depth semi-structured interviews with soldiers who had taken part in asymmetric warfare missions. The second, published in the book Junior Leadership in Afghanistan (4), contains a series of detailed memoirs written by Dutch platoon leaders who participated in missions in Afghanistan in the period 2006-2010.
In both cases it is a matter of personal testimonies: in the first referring to a number of theatres (5), in the second limited to only one (Afghanistan) but certainly the most significant as an example of asymmetric conflict. Although the two researches adopted different methodologies, the testimonies are fully comparable and show that soldiers from different countries and cultures display common or similar reactions when they are placed in the stress conditions that the asymmetric environment involves.
The approach that follows is drawn up in such a way as to make the reader a participating observer of the reality of such missions. It is therefore centred on the personal testimonies of the soldiers interviewed in the two researches, testimonies reported just as they are, in their simplicity and, often, drama, with comments by the author kept to a minimum in order to give readers ample opportunity to evaluate and interpret the reported texts on their own.
2. THE LIVING CONDITIONS OF THE SOLDIERS SENT ON MISSIONS
The soldiers of the 10 countries examined in this study all came from contexts characterized by advanced democracy, effective governance, privileged economic conditions and temperate climatic situations.
In most cases, the countries to which they were sent on mission did not share any of these characteristics.
Indeed, the interviewees' responses show significant distress over the impact of the environmental reality of these countries and their stays in them.
These soldiers had to contend with three environments while on mission: the natural environment, the human environment, and the operational environment.
The natural environment presented itself in most of the cases as desertic, arid, often quite compartmented, with large seasonal and daily temperature swings, frequently at extremely high levels.
This is clearly present in many of the answers given by the interviewees (6), such as:
SAC09: The first thing I had to deal with when I arrived at Sudan was the weather, because it was extremely hot and the language, the culture. Since Sudan is a different country from SA, I was not sure what to expect.
KRA01: I had a feeling of desolation due to hot weather over 50 degree C. and sandstorm. I was worried about life over the next sixth months since all the roads leading to the unit were located in desert.
Dutch Lieut. Geert: I first flew to Minhad, where I participated in the acclimatization programme. The climate was inconceivable here: it was uncannily warm and enormously humid at the same time: The temperature would sometimes mount to 63 degrees Celsius, while the humidity was 97%. I thought I was losing my mind....
Dutch Lieut. Geerten: The camp was one great sandy plain with a few concrete strips. There were some Bingham tents scattered here and there ... used as sleeping accommodation for approximately 250 men each ... there was no airco, so that the heat inside would reach rather high temperatures.
ITC25: I arrived in Iraq in summer and my first impact was that on climate (we were lodged in tents). Under an operational point of view we met a desert scenario, totally news for us.
Moreover, the climate and environment conditions are (unfavourably) compared with those of the soldiers' home countries:
SIC03: When arriving to Afghanistan for the first time he thought he arrived at the end of the world. Everything was very dirty. Afghanistan is one big garbage place. Landscape is completely different that at home. Nothing at home can be compared to Afghanistan.
KRA10: Weather and environment were so different from Korea and thus, the first impression was mostly related to the climate in the Middle East I had never experienced before. It was very surprising to know that people could afford to live in such an environment and I also thought Korea is a good place to live.
SIC09: Afghanistan is definitely a completely different environment, no vegetation, only desert and sand. The change of environment surely has effect on a person. First, you have to get used to different weather conditions, to high temperature differences between day and night. Adapting to new environment takes at least 1 month. Way of life in Afghanistan is completely different.
The personal hardships that these environmental conditions entail are repeatedly and openly stated by the interviewees:
KRA05: It appeared to me strange because of sand wind and empty desert, and living quarters built by container boxes and weather made me very uncomfortable.
Dutch Lieut. Marcel: The working conditions had been heavy, especially during the summer period because of the enormous heat. When you have to work in such conditions, when it is really hot and you move out with all your gear, your body is taxed heavily.
BGC04: I got into a new world. Complete obscurity. Everything was new for you and you did first steps as a toddler.
But what probably strikes the human sensibility of the soldiers on mission even more is the human environment that surrounds them in these countries with which they are forced to come to grips. The conditions are often primitive, miserable, and of material and at times moral degradation, characteristics of the backwardness of these countries and further aggravated by grave conflict or post-conflict situations that seem in terrible contrast with the relative well-being and serenity of the soldiers' home countries.
This condition of distress that is no longer only physical, is extensively testified to by the interviewees.
ITC95: I was shocked passing from our civilisation to the backward one of the countries where we were carrying on our missions. There I have seen strong poverty and people suffering it.
SAB15: I was very shocked of the way the place looked and the people. My first thoughts were "how do people live like this?"
TURA03: Smell and vision of misery and chaos surrounded me when the doors of the plane are opened. I thought that these 6 months were going to be hard for me. I wished that I wouldn't have been there. In the first days I thought there was no order and rule in this country. And God had forgotten this geography. I can say that I was realty in a bad mood.
DKC02: Overwhelming--far removed from anything I had ever seen before. I had never been out of Europe before. The smells, people who "tumble" around you. Afghans are very different in terms of hygiene and mentality.
SPA02: Regarding his first mission (Enduring Freedom, led by US), after the harsh impact of climate conditions, he was shocked by the economic inequality of the local society, with a narrow rich class and a broad poor class.
PHIB05: Sometimes when you are faced with extreme poverty you really pity the people who need so much in life.
PHIB03: The communities that we go to are really poor/depressed. These are the people that really need help and assistance.
Dutch Lieut.Rob: There is actually a thing that really bothered me and that was the way in which young boys were abused as sex objects. These situations I found personally very hard, the way the local men treated these children. It was a phenomenon of which everyone could see that it had permeated the Afghan culture to the very core ... I saw an ANP officer negotiate with a father of a small boy, who an hour later would be delivered again to daddy.
SPC18: In Sarajevo I was much shocked by the damage of the city and the hatred that yielded to such a cruel war.
ITC55: When I arrived in Sarajevo the consequences of the war were evident: my first impression was of an exhausted country.
Right from the first impact with the mission theatre the operational environment in which the soldiers have to carry out their mission presents itself in all its severity and drama.
ITC17: In Iraq the level of threat was higher and we had to experience a plurality of assets, putting at stake our professionalism; besides, the area of responsibility was wider, we met the social problems by the division of populations in different tribes, clans, religious sects, etc.
SIC44: After his airplane landed, he noticed hard injured German soldiers who were transported by the helicopters to the hospital. He also noticed the all NATO flags were always on half-mast. The first impression was, the real war is going on.
ITA04: In Iraq I had to relieve my colleagues fallen in Nassirya: therefore it was a strong impression under an emotional point of view.
DKC14: The soldiers we had to replace looked very tired, which says something about how tough a mission this was.
Dutch Lieut. Erik: My predecessor had just lost Corporal Ronald Groen in an IED [Improvised Explosive Device] strike. On our arrival at Camp Holland we made a tour of the camp and we saw the Fenneck [armoured vehicle used by the Dutch army] with which the corporal had hit the IED. We could see the consequences of such a strike and it made my drivers realize that their position in the vehicle offered little protection. This was a very confronting moment, not only for my men, but also for me...
ITC27: Both in Iraq and in Afghanistan you live in a narrow room, where you have to live together with persons from other countries. In both two countries you perceive a feeling of threat: our base was often hit by rockets and when you are flying with your helicopter often insurgents shoot you (We had four helicopters holed).
ITB01: The Persian Gulf is a very particular environment: you can perceive a feeling of danger in all the ships that navigate there.
Drama is then further and heavily confirmed in the course of the mission through episodes and situations experienced by the interviewees:
ITC95: Unfortunately some mourning events happened, particularly in our job as artificers. Usually you don't think of danger: you think it when something happens and thus you must have the strength to start working again.
ITC91: Once I had the task to protect with my platoon two gun artificers who had to defuse an IED that had exploded and killed them both. I had to manage the recovering and evacuation operations.
BGC15: Yes I had been subject to enemy fire. Almost daily mortar fire. On 20.7.2006, the 107 mm missile crashed directly into the wall of the business office on the outskirts of Baghdad, which was half-destroyed from the inside.
DKC01: In Iraq, we were under rocket fire for 85 days, where we fell down on our stomach. You could almost set your watch by the shelling. It was probably the heat that made them shot at certain times.
ITC22: I was involved in a big fire conflict on June 11, 2009 and appreciated how my mates reacted to the fire. I was in command of an armoured craft ("Lince"): my machine gunner was wounded on his arm, but he remained at his combat place. The craft behind me was heavy hit (two casualties) and a pickup of the Afghan soldiers was blown up by an IED: I talked with them few minutes before and was particularly hit by their death.
PHC10: Since I have joined operations under fire many times, hardships and fear in the presence Of the enemy are my initial feelings. I have learned that in every encounter as long as you are in service: protect yourself first, do something that will protect the civilians so that the image of the military will not be ruined and never do something that will imperil the civilians.
ITC02: I was involved in fire conflicts. It was a very strong experience: it happened particularly during our patrolling (fire with guns, RPG, etc.).
SAB6: It was the first time in my life that I was ever in a real attack by such heavy artillery. I felt very scared, thought about my family. Thought that if this day was going to be my last that experience made me think positive about life.
Dutch Lieut. Dennis: After walking a short distance I found an Afghan lying in a ditch with a smoking machinegun, a PKM, at his side. H had been hit in the head, just outside the eyes-nose-mouth triangle. A large part of his skull was damaged, but he was still alive. I saw he was in great pain....
BGC26: Yes. I have got into improvised explosive devices We were patrols near "Afak". We noticed that we were being shot at with a video camera from the roof. Quickly warrant squad was returned. We alerted local police, breakaway the region. Luckily it was not installed properly. The cable was broken and it saved us from the explosion.
DKC21: We had only walked for about a half hour and could still see the camp when we hit the first IED. It exploded in loose soil, between me and the guy behind me. We were both bowled over and it took a few seconds where I just lay on the ground and thought 'what--just happened?" Fortunately none of us were seriously injured.
PHA11: When I was assigned in Mindanao, the combat operations were brutal. In Cotabato, in one instance, my fellow soldier was killed after he fetched water.
Dutch Lieut. Barry: After the attack on the bazaar the men of my platoon and I saw the dead bodies of the children. Together we cleared the market after the attack. It was utter devastation and the place was extremely filthy. I first formed a security cordon and then selected the emotionally most stable men of the platoon to clear away the mess.
Dutch Lieut. Gerwin: It was Monday 31 March. In the surroundings of Mirabad a Fenneck of the ISTAR platoon had hit an IED, causing three seriously wounded. One of them would eventually lose both legs.
An outlook on the situation of the environment in which the soldiers find themselves living and operating that is clearly in itself capable of causing the physical and psychological distress in them is also part of the study's focus. In particular the soldiers' fears concern not only their loss of life but of being maimed as well. The insidious danger of IEDs (the number one cause of casualties in Afghanistan, for example (7)) is particularly feared for the most frequent physical injury, the loss of legs. This consequence is suffered most often by the drivers of armoured vehicles due to their particular position in the vehicle (see the testimonies of Lieutenants Erik and Gerwin above). In addition, IEDs also pose big problems for the clearance and removal work: in this regard see the testimonies above of IITC91 and ITC95. Also the sight of the outcomes of the fighting appears to be perturbing and apt to produce feelings of horror in the soldiers, so that Lieut. Barry states he had to charge "the emotionally most stable men of the platoon" with removing the bodies of the dead.
3. THE PSYCHOLOGICAL CONSEQUENCES
The psychological stress situations already amply documented in the American literature for U.S. military personnel and to a large extent grouped under the term "post-traumatic stress disorder" thus emerge also for the soldiers of the countries examined here (see, for example, Adler, A. B., Carol A. Dolan, 2006; Ward, W. 1997; Richardson, J. D., J. A. Naifeh, J. D. Elhai, 2007; Andrews, B., C. R. Brewin, R. Philpott, L. Stewart, 2007) (8).
In particular, as Alessia Zanetti (Zanetti, 2014, p. 13) observes:
"... in the 1980s the American Psychiatric Association, with DSM III (Diagnostic and Statistical Manual of Mental Disorders) defined a new diagnostic category: the syndrome of PTSD (post-traumatic stress disorder) was formulated. The wars of the twentieth century were an important incubation place of this category; already in the Russo-Japanese conflict of 1904, exploding grenades caused paralysis in soldiers and emotional blockage, defined as "shellshock'. The coming of the world wars and the theories of Freud's followers confirmed the direction taken by the studies. Psychoanalysts like Sandor Ferenczi, Karl Abraham, Ernest Simmel, Abram Kardiner and Otto Fenichel elaborated various definitions and therapies in this regard."
Our research, however, extended beyond simple post-traumatic stress disorder to include three different aspects of psychological distress resulting from mission participation: the stress due to the operations themselves--operations which for many entailed involvement in firefights for the first time; distress due to long periods away from the family; and difficulties of reintegration into everyday life back home upon returning from the mission.
Participation by these countries' soldiers in peace-making operations in various theatres (see note 5) led to the involvement of their armed forces in missions that are now known as asymmetric warfare--to which they were not previously oriented--with all the implications in terms of risk, difficulty and sacrifice that participation in this form of warfare entails. This new use, which has become generalized in the last ten years or so, has affected the armed forces of countries with little or no previous experience in combat operations. By choice (9), the countries examined in this study are small and medium powers engaged until recently only in what have been termed MOOTW (10). Their armed forces therefore found themselves for the first time on these missions facing combat actions in the particular environment of asymmetric warfare, an environment much more difficult and challenging than "conventional" combat operations.
3.1. Emotional stress during and resulting from operations
The risk of attack by insurgents blended in with the civilian population, of ambushes in which many soldiers of the surveyed countries had their "baptism of fire", the danger of IEDs, the launching of rockets and mortar rounds against camps, the losses suffered, the sight of the dead and wounded, experiencing the loss of fellow soldiers and friends constitute a series of factors and events that are undoubtedly apt to produce situations of great anxiety and stress in those who undergo them. Here are some experiences:
SIC01: On the day of their arrival one NCO of the Afghanistan National Army had shot and killed several of his soldiers, and also one American soldier. Consequently, strict restrictions regarding entering the base were taken. First day was very shocking, later situation calmed down, until 1 month after the arrival when missile attacks on a base were on an everyday basis.
SIC46: The most stressful situations were when Italians and Spanish had victims at the same roads where also Slovenians were patrolling.
ITC32: In Kosovo my first impression was the face of war: destroyed houses, everywhere signs of shots. In Afghanistan the impact was different: just gone down from the airplane, they distributed us ammunitions, the travel was in escorted armoured crafts. You can perceive tension in the drivers.
Dutch Lieut. Peter: The action was mentally very taxing. A number of men had looked almost straight into the eyes of the opponent they killed. At the same time, one of their buddies was badly injured.
Dutch Lieut. Geerteb: Evidence of the shrapnel of the detonated grenades that had struck the police post were clearly visible. The scene was searched for live as well as detonated munitions. It was a messy business. It was sweltering hot and the men's body parts were baking in the sun, which produced a sickening stench. Not only had the search for possible other explosive devices to be done near and under the men's body, but also inside it, which left a deep impression on most of my men.
Dutch Lieut. Stellan: These were difficult assignments and, not surprising, my men indicated afterwards that these assignments caused them anxious moments.
DKC21: Stress while I was there. I worked with it by formalizing all conversation about things. Being a chief (major) of a company you reduce stress: e.g. when a unit has been in battle--they debrief. When we have so many with stress it is because we have big problems: 5 killed, 70 wounded in Afghanistan team 9. 7-8 psychologists down here....
Dutch Lieut. Erik: At a certain moment that night a fire fight started. As I was listening to the radio I heard a live message from the C team's commander saying that there were two men from his unit that showed "no vital signs', ergo they are dead. This message had a huge impact on everybody. Nobody knew what had happened exactly. The impact was even more acutely felt because it meant that the insurgents were capable of attacking us in the dark.
SIC47: He saw how one suicide bomber with the motorbike attacked ANA soldiers who were coming home. He still remembers the date of this attack, which happened 400 m away. He was full of adrenalin, very upset. This was for the first time, he filled the weapon.
Dutch Lieut. Erik: One of my sergeants later told me that the experience [of assisting a wounded man] kept him awake at night. He had seen that half of the wounded man's leg lay besides his body, which caused him excruciating pains. My sergeant then moved the leg to a more comfortable position. Although my sergeant and his men felt good about what they had done to help their colleague, the images of that night were branded on their retinas.
PHIC14: There was fear of the unknown. I have heard stories previously of seniors and fellow soldiers who died in the area where you posted. In fact, I replaced an officer (a senior military academy graduate) who was killed. We are all human after all, not immortals.
Dutch Lieut. Gerwin: ... In an IED strike in the surroundings of Khorma two men had been killed and two seriously wounded. He told us who had been killed. I knew Dennis van Uhm quite well. We had spent an evening in Amsterdam shortly before the mission, together with the company leadership, and these thoughts flashed through my mind. One of my men went completely out of his mind when he heard the name of the second casualty. He and Mark Schouwink had been the closest friends ever since they were children.
PHIB10: The killing is one of the things that I really need to adjust to. I value life but you have to make a choice either you be shot or to shoot the enemy.
Added to the typical emotions of war, of finding oneself threatened by enemy fire, are the particular frustrations typical of asymmetric warfare, summed up in the following example:
Dutch Lieut. Erik: Counter insurgency is often frustrating. You are fighting spectres. People are walking about in civilian clothes and have hidden their arms underneath. You are only allowed to react when you are fired upon, but not in all cases. Or you are not allowed to react with all the means at your disposal: you have to be careful not to hurt any innocent civilian.
The states of mind created by experiences like those listed above were described as follows:
DKA03: Mentally tough to eat breakfast at 07 o'clock with colleagues, at 10 o'clock to pick them out of a fight--died at 24 o'clock, to say goodbye to them where they lie in a "coffin"--how quickly life can disappear, and the pain the survivors now face. Hard--day after day having to be mentally ready to die in a few seconds--and the pain it will give your children and family.
BGC15: What were your feelings prevailing during the mission?
Sense of risk and frequent fatigue. Lack of regular information on loved ones in Bulgaria. Lack of torture fears.
SIC23: Work on check point is always stressful, you never know when a suicide bomber will strike and if you have intelligence. In this way stress is even higher.
Dutch Lieut. Maarten: During the fight I also felt anger and aggression. There was a lot of adrenaline racing through my body and once the unit was in a good position, the anger pushed me to go on with the fight. How dare they fire at us! Perhaps it was not realistic to think that, but the realization that others wanted to kill me and my colleagues, while we were doing our job with good intentions, really made me angry.
DKC07: Yes, I have had respectively psychological and stress symptoms, during many of my missions. Mostly, I worked with these symptoms myself by "promising myself that I would not come home with scars on my soul". Whether this has succeeded 100% I will not comment on but leave that to others. I have in the SHARP missions always written my experiences in diaries which I have felt has been a great help.
Anonymous (page 345, Groen 2013): I had a section commander who would always be the first to do everything. No assignment was too much for him, until he was personally involved in an IED strike. In his view, he was driving precisely in the tracks of the preceding vehicle, but unfortunately that was not the case. Fortunately, he was driving in a Bushmaster and there was hardly any damage. After this strike his behaviour changed. He had had it....
SIC39: The most dangerous situation was when his base-camp was under insurgent rocket fire. Because these arms were more or less improvised, precision was bad, this was the first case he was exposed to direct threat. He was surprised how he was reacting because he had almost 20 years of military experiences but real threat situation is something completely different.
SIC40: The feelings? He saw the threat as a matter of destiny. If you had luck, you would survive, otherwise not.
DKA04: You go in a high gear during the operations, and it can be difficult to calm down afterwards.
Dutch Lieut. Bart: I noticed a certain enthusiasm in everyone that had been in the firefight. This enthusiasm arose from the fact that everybody had been really shot at and nobody was wounded. This enthusiastic posture is probably part of the infantryman's psyche.
SIC34: No combat operations, but we were prepared if something happened. Sometimes it's kind of the dream that doesn't come true--you are being trained for a hard job, but at the end of the day you don't get what you wanted. On the other hand when you think that you may die, it's good that we weren't engaged in difficult situation, we survived, etc.
Anonymous (page 342, Groen 2013): The gunner of an armoured vehicle is reasonably well able to see the effects of his weapon in details. In the evaluation one gunner was constantly talking about a camel. It turned out that during a firefight he had accidentally hit a camel.
In the same action he had neutralized a Taliban fighter. He had seen that he had hit the man, but he had also seen the camel suffer with pain. He finally released the animal from his sufferings, but the entire incident made a deep impression on him. I am sure that shooting the camel had more impact on him than killing the Taliban fighter: the camel had in fact nothing to do with the incident, but had become involved anyway. It led to mental problems for the gunner.
As can be seen from the testimonies reported above, a number of feelings and sensations are caused by the experiences in the field, ranging from simple fear, which does not fail to make its appearance even among those with the longest military experience, as SIC39 observes ("real threat situation is something completely different"), to resigning oneself to one's fate in a kind of reassuring fatalism (see SIC40 above), to the adrenalin rush caused by active response to a risk situation (DKA04), lived positively when it had not involved losses (Lieut. Bart), to a change in outlook when danger had struck closely (Anonymous, page 345; Groen 2013), to hesitant regret when the firefight does not materialize (SIC34), to "mental problems" for having made an animal suffer and having to kill it, etc.
To control the anxiety and stress caused by combat situations the interviewed soldiers resort to various expedients: distractions like physical activity, reading, keeping a diary, and watching films and videos; seeing psychologists attached to the units, where there are any; seeing military chaplains, for believers; talking to their direct commanding officers; group debriefings, where they are held; seeking refuge and reworking the trauma within the small group to which they belong (11).
But let us look at a few examples of the various strategies used by the interviewees:
BGC03: Did you do something to keep your mental condition of the normal level, if yes--what?
In the second half of the six-month mission I was able to use the gym almost daily. I was falling asleep reading recreational books, for example, downloaded from the Internet jokes--in Bulgarian.
DKC15: Yes, had some anger problems. I ran and exercised and it helped. It disappeared about 5 months after homecoming.
TURA08: To prevent any psychological problem, almost every day, I went to gym for at least one hour. This makes you feel good and discharged. Barbecue parties with friends and Turkish colleagues and having internet access and DVDs were also very useful.
BGA17: Contacts with colleagues and neighbours in my spare time; fitness or running daily or at least twice a week; books. It is desirable that contingents be provided with books or newspapers and magazines from Bulgaria.
BGA18: The main tool for me personally was the sport; enjoyable reading that carried me elsewhere, as well.
SLO10: You have to find your own stress coping strategies. Sports are one of them. You can lose your mind if you think about the danger of missile attacks every day.
SAC5: I experienced stress on the fourth month and then I made an appointment with the social worker and it helped.
BGC17: Sports activities and contacts with officers from the German and Italian contingents.
BGC10: Daily contact with my family; regular visits to the gym; spontaneous visits to the U.S. market and shop; meetings, banquets with colleagues.
BGC07: I spoke with a psychologist of the contingent.
PHI10: Although we nave Posttraumatic stress disorder debriefing, it is not done on a regular basis.
PHI13: Our unit had stress management lectures in order to help us cope with the changes in our life.
SAC07: Talk to the authorities like psychologists, chaplains and commanders.
TURC03: Being a soldier is stressful. Doing this job in Kabul is much more stressful. Risk, climate, foods, rules were all stress sources for me. But I came over it by thinking of the end of the process. It was just 6 months and after it I was going to start a 2 years master degree education in Land Force Academy. So dreaming about good things always works for me to get over my stress.
Recourse to the "primary group", however (see Stouffer, 1949), appears to be the most important and meaningful support tool for the individual when faced with anxiety and stress situations during (and sometimes also after) the mission. Indeed, ever since the research of Stouffer's Research Branch it had been known that it was the primary group that induced individuals to remain in combat situations without seeking ways to escape. A situation identified by the Research Branch as an extreme stress condition is when nearly all the individual's needs are denied gratification, the threats regard the essential aspects of the person (life, physical integrity), radical conflicts are created in values (moral codes--codes of conduct), and anxiety, pain, fear and uncertainty prevail. In the framework of the group the above deprivations are not seen by the individual as absolute, but relative to the levels of gratification and the aspirations of the reference group. In the combat situation, for the individual deprived of everything, the psychological and affective gratifications offered by the primary group thus become essential, irreplaceable, unique (see also Caforio, 1987).
In confirming the ample, generalized recourse to the primary group to rework the moments of stress, the data of our research also confirm the similarity of the traumatic effects of asymmetric warfare operations and of those already identified which are characteristic of conventional combat operations.
Testimonies to this recourse are numerous and are seen in all contingents.
SPAC12: I had stress seldom. I sorted it out thanks to my companions, who were fundamental in that kind of situations.
SAA01: As mentioned above, these situations brought about a lot of stress but as soldiers we overcame them by talking about it and socializing with other arms of service.
TURA29: Yes. Sharing with close friends was a good therapy for me.
SLO40: Every indicator of stress was discussed in the group, where great confidence existed.
ITC31: Yes, I had some moments of stress and fear: speaking with colleagues helped me.
ITC91: The casualties we suffered in Afghanistan certainly caused stress, but the mourning was elaborated inside the group, without consequences.
SIC38: Personally he had not confronted with stress problems, but stress is a matter of individual person and reaction. Considering the Slovene contingent, they tried to get over the stress with "family" meetings, where every Slovene participant could express one's own troubles. They had stress problems, no doubt, but were trying to keep discipline and moral on high level.
KRC56: Of course, I had a stress problem, but I received plenty of psychological support from team members whom I trusted and relied upon.
DKB02: Yes a little, but I've talked a lot with colleagues and friends about it and got through it fine.
SLO01: They used intense communication with each other as a stress coping strategy.
ITC55: Missions produce stress: very important is the help of your small group.
DKC14: Yes, I am only now becoming fresher and not so tired every day. Talked with the platoon leader and colleagues here at home and others who have been in ISAF.
SLO33: I didn't need any help from a doctor. The support usually came from the contingent, because we were really a good team.
PHI10: To be able to handle the after operations psychological trauma, you need to talk about it. You should not keep it to yourself which may be the reason why the Marines love to drink because these drinking allow them to share their experiences openly.
ITC96: We had some difficult moments when mourning incidents happened, but the mate group helps you.
TURA16: I had some problems during the mission change phase, but my experiences and close friendship with my colleagues helped me in overcoming these problems.
SAC51: The mission can be stressful because of lack of support from the supported force. I had a good working relationship with my team, so it was easy to deal with such stress.
SPAB30: The anxiety level raised much when the day after we had a flight in which action was expected. Materializing especially at bedtime when reviewing time and time again the plans I had to perform the following day. I sorted it out with sports and by talking with mates.
A particular institutionalization of recourse to the primary group is the practice of debriefing, used by various armies, where right after a mission on the ground the organic unit, normally at the platoon level (12), meets to examine and elaborate the experiences, even dramatic ones, underwent in action. See, for example:
Dutch Lieut. Peter: The ferocity of the contact and related events yielded enough material for a number of conversations. For the first time I applied the concept of debriefing as I was wont to do after every subsequent contact ... In accordance with the concept, immediately after the operation I took everybody out of their vehicle and into the tent for a hot debrief ... After a first assessment of reactions a hot debrief served to enable the platoon to let off steam.
Moving to a quantitative analysis, we can say that, for the soldiers interviewed in the Soldiers Without Frontiers research (13), the data are as follows. In the overall sample three soldiers out of ten declare that they experienced moments of anxiety and stress during the operations. In particular, out of 542 interviewees, 273 (51%) stated that they had not had problems, 118 (22%) did not answer the question, 94 (17%) reported "normal stress that could be handled", and 55 (10%) high stress.
An interpretation of these data cannot go without noting the high percentage of failures to respond (22%). It would not be stretching the truth to point out that this high percentage may in large part be due to a natural reluctance on the part of soldiers, especially if career military, to admit to having had moments of fear or anxiety during operations. The percentage of those who had moments of operational stress can therefore be considered to be higher than the 27% reported overall.
The principal stress factors during operations were the uncertainty of the situation, "a permanent threat, one didn't know from where," actual exposure to attacks, ambushes and, with a higher degree of anxiety, the wounding or death of comrades-in-arms. Worries expressed by responses such as the one given by an Italian soldier: "Yes, I found myself facing stress situations: wounded fellow soldiers, involvement in firefights, rockets against our base, etc." Or by a Korean helicopter pilot: "I felt strong stress each time I flew and thought this time might be the last day of my life because there was a high possibility of being hit by missiles at any time during flight." Or by a Bulgarian soldier who states: "Naturally, these fears were focused on self-preservation and survival in this neuralgic life risking environment."
But also other anxiety factors are created in operations of this type, such as concern about being able to perform one's task, as expressed by a Korean soldier: "In many cases anxiety prevailed about my ability to successfully carry out the task that had been assigned to me. "Or the difficulty of regaining one's mental equilibrium after a combat action (a Danish soldier): "You go in a high gear during the operations, and it can he difficult to calm down afterwards."
3.2. Psychological distress due to long separation from the family
This type of problem chiefly regarded soldiers who had left a family of their own (spouse and children) back home. As it is well known, the family is a "greedy institution" and places itself in a dual, controversial relationship of competition/cooperation with the military, which is also deemed greedy (see in this regard, among others, M. Wechsler Segal (1986), or also, for the concept of "greedy institution", Lewis Coser (1974)).
The importance of the problem for the soldiers' morale is evidenced by various interviews, such as the ones below.
Dutch Lieut. Stellan: There was the effect of the relationship I had during my second mission. I was no longer single: I knew from the talks I had during my first mission with my 2iC and the section commanders who had relationships that their home front was on their minds. I think it is logical that somebody with children experiences the situation differently where the sense of responsibility is concerned.
ITC55: Family problems: My girl friend left me.... I recovered my links with my old family.
DkC16: Both / and ... Not while I was away. Was divorced shortly after AFGH. Was "alone" in relation to Iraq!
ITC58: Yes, I had problems with my wife, which culminated in a separation three years ago. I am realising that have devoted too few time to my family.
TURA11: Yes I had problems. One of them was my son's school success worsened.
ITC64: Yes, particularly after the 2007 mission because my long absence, I found a difficult situation in my family. My daughter missed one year of schooling.
SPB30: Yes, I have had problems especially with my wife and my sons. I have learnt the unpleasant experience of your own son not recognizing you and weeping after not seeing you for four months. My eldest son has had adaptation problems in the school during my absences. He became more violent and sad. In terms of couple, we suffered a distance with each mission, solved by great efforts from us.
SAA1: Yes, especially if we are married, the time spent away from them can get to a person and on some missions there was not much communication. This made the separation unbearable and many of us tended to get frustrated with other members in deployment.
TURA21: My dad was so sick and that stressed me much. Besides I had my grandpa passed away. Due to the medical problems of my family, I was subjected to psychological problems and had pills.
SAC43: It was a problem, because my son had an injury that he was even operated for on his leg in my absence. It was not easy for me to cope in the deployment. My cousin also passed away.
TURA25: My daughter was born during the mission and I couldn't spend a long time with my daughter. I couldn't support my wife during the most difficult stages of the birth period.
DKC18: YES, I have three children. After returning, it has been difficult to find my place in the family again. They learn to cope without father / husband so there is not much "space" when you come home.
SPC18: I had some. I disconnected from home problems. One tends to think the domestic problems are null compared with the mission reality, but that view is not shared by the partner, which may lead to an argument. To be far from home can't be good, especially being so far and for so long. Internet has been a great help to get closer to our families. Access to internet for everybody in our bases must be always guaranteed.
ITC72: No problem: we got a strong support from our parents, both mine and those of my wife. If you need, the military institution created some support team.
SPC06: I've had problems with my family. I didn't divorce, but I had problems. Right now I am Lieutenant, but if I am going to be promoted nobody likes to be married with a person that spends ten years far from home. There are people with seven or eight years abroad if we sum their missions up. It depends on your resilience, too.
In confirmation, many of those who state that they did not have problems due to separation from the family give credit to the spouse who stayed at home or, in some cases, to parents and in-laws. For example:
TURA33: Since my wife had a job, her father and mother had to live with her to take care of my daughter.
SI18: My wife had to simultaneously take care of two small children and hold down a job. She was helped by her family.
As can be seen, there are essentially four types of distress resulting from forced separation from the family: the breakup or crisis of the relationship between the couple; hardships for the children, which often take concrete form in declining performance at school; absence on the occasion of important events for the family (death of relatives, births, etc.); and difficulty of reintegration in the family after a period of absence (this will be looked at more closely in the next section).
Although the period of absence is basically not very long (six months on average), one must consider that, in most cases, these absences are repeated at short intervals. As the Spanish soldier quoted above (SPC06) says, "There are people with seven or eight years abroad if we sum their missions up."
From many responses given by the interviewees, the possibility of convenient, frequent use of the Internet, especially the Skype telephony service for voice and video communications, is fundamental for alleviating problems caused by separation from the family.
To complete the discussion here as well with a quantitative analysis (made with the reservations outlined earlier), we can say that out of the whole sample of countries in the Soldiers Without Frontiers research, 45% of the interviewees report not having had any particular problems due to separation from the family, 16% say they had a few problems but not particularly serious ones, 22% had rather serious problems, and 17% fail to respond. Still staying with statistical data, it is found that those who participated in a greater number of missions had fewer problems of a family nature: 64% of those who went on more than six missions declare that they did not have any problems due to separation from the family, nearly 20 percentage points more than the sample average.
These data confirm that separation entails real psychological distress for individuals, distress that for 22% appears to be fairly serious and whose consequences mainly affect relationships between couples and their children.
As said earlier, this distress decreases as the number of missions increases. Two explanations can be given for this fact, not necessarily in conflict: the first is that habituation to separation gives rise to compensating instruments and/or behaviours. The second is that those who accept to go on missions more frequently either do not have a family or succeed in coping better with the temporary separations they entail.
3.3. Readaptation to life back home after missions
There is an abundant literature on the difficulty of readapting (14) to everyday and family life for veterans of asymmetric warfare missions, just as was the case in the past for veterans of conventional conflicts, but it is especially abundant for the major powers, which already have significant experience in out-of-area military operations, both conventional and asymmetric. Often it is precisely these difficulties that constitute a symptom of the posttraumatic stress disorder that is sometimes later clinically diagnosed. This is so well known that some armies (the Dutch one, for example) have instituted a "decompression" period, that is, a short stay in a suitable locality outside the country for units that have completed their mission before returning to the homeland.
For the soldiers of the small and medium powers examined in this study the testimonies collected are of the following type:
Dutch Lieut. Barry: Having returned to my work ... after a time I noticed that I suddenly was not doing too well physically. I did not feel well and got a number of short batches of illness: a fever for a maximum of two days, diarrhoea, throwing up. All over my body I discovered these small spots, a kind of psoriasis. Something is wrong, I thought. I saw a doctor and had a good check up, taking some blood ... At one moment my doctor said. "Perhaps it is your head, instead of somewhere else."... She was right....
DkC21: Difficult. To all who ask, I reply that it is easy to go to war, but hard to get home again. Unfortunately I have not really been able to return to a normal life. It is now 6 months since I came home and I am just beginning my graduate study and now feel that my life is moving again.
Dutch Lieut. Gerwin: I think that everyone going away on his first mission, returns a different person... Everybody expresses this in his own way: one person gets more aggressive and the other a bit more reserved.
ITC33: When I came back I remained for a couple of months rather impulsive: I was irritated by the luxury, by the superficiality. I have seen what it means to live and to combat for surviving, have seen dead and wounded people, it was really hard.
DKC20: On the one hand, it has been easier than I thought; on the other hand, I feel an insecurity and isolation. I'm irritated by the press and media, I am disgusted by people's constant interest in money and consumption. The ideals I worked for at times seem distant in our society. It is as if there is a civilian and a military code of honor and ideal.
SPAC03: I had some problems with readapting to normal life, because you come back home with a different mentality. It is quite complicated to readapt to normal life. But my family has fully supported me. For instance, once back home I went with my family for shopping. My son wanted me to buy him a tracksuit. Its price was 30 [euro], which is quite cheap, but I told him it was too expensive. Then, my wife reminded me I was in Spain, not in Afghanistan.
SAC13: Slightly difficult in the beginning being back home. The disasters in the mission area stays in the sub-conscious mind and yes, I don't think that one can forget easily the heartache and pain of their lives.
ITC92: Gradually you adapt yourself again: there are experiences that you cannot share with people who didn't live them.
ITC81: Some difficulties in the first period after the mission (you cannot share your experience): life rhythms are different.
ITC29: In the first days after the mission you look around in a very attentive way, you control the road, etc. At the end you become calm again.
SAB06: It was difficult to adapt, because in the mission area I would get up at all parts of the night, because of all the shooting going on and now you back home, it is peaceful, but you get up and look around to see if it is safe.
Anonymous (page 381, Groen 2013): Soon I noticed that my rational and emotional feelings were conflicting. The first time 1 went out on the town in Amsterdam with friends of mine I noticed that I was still checking out the security. I could not let go of what I had done all these months in Afghanistan. I kept on the look-out for certain signals.
DKC16: I've been under fire in Somalia ... But otherwise it's probably AFGH that have made the greatest impression on me in connection with IED's but simultaneously also demanded more of me. In AFGH I was under U.S. command + part of C-IED / branch in Kabul. Each day was a challenge because I was also team leader of a QRT / C-IED. The short version is that when the phone rang / sms'ed you never knew what was waiting in the city. It could be something that was found / or after something had blown! We had some so-called "cover-on", i.e. "stuff" put out to lure us out. Often in the aftermath of an IED in the area, it was the probably the worst + that the spectators themselves were often the bombers themselves--anyhow that was our belief. All this has resulted in that I still today, some 3 years after react to the sound of an sms.
SIC20: After mission you need some time to accommodate to the regular reality of life in your family and working surrounding. You have to cool down your readiness to act at any given time; your reaction must become less instrumental.
SAC46: When you come back home, you feel like a stranger to your own family and you always find that a lot of things have changed, including your own spouse, so I feel that it is a very big sacrifice to make.
Dutch Lieut. Erik: My little daughter really had to get used to my presence. During my leave my wife was working and I was alone at home with my daughter. I very much wanted to do things for her, but all she wanted was her mummy ... I took more than six months before things were back to normal again.
ITC26: A few problems upon getting back, as with others. Readapting to the family environment isn't easy (nor is it easy on the family).
SAC28: I took a month to join my family the way they know me, I wanted to be alone and agree, they asked me questions like "why are you like this'. I told them nothing is wrong with me, then I adapt until they told me now I am no longer the same, I am good again.
DKC02: How did your re adaptation go to normal life after the mission?
Strange. You are "high' up and running with a heavy workload at 90-100 hours a week and then you go home to nothing. But I was prepared that it took a half year to get home. I had a feeling of emptiness that I had to accept, perhaps a depression. I probably was anxious until Christmas.
SPB02: It takes an effort to readapt once back home. Few months in children's life is a lot. There are new habitudes, decisions your wife has taken in your absence one must deal with, and sometimes you disagree with them. It's not a hard time but it's a little bit stressful. It takes a pair of weeks to resume normal life.
SAC29: It is very difficult to adjust your life after mission; young children don't even recognize you as a father. When you get home, people have been living without you, so you have to be patient and get back to that routine.
SAC54: When I arrived back my Major was very supportive. I fell back into my military routine and slowly got used to "having the freedom" to go to the shops or wherever I wanted to go without having to report to anyone. Some of the other guys had issues. They found their wives/partners demanding--they just wanted to be left alone -felt under pressure.
DKC04: It's been hard to get myself back home. I've just been admitted to a psychiatric hospital. I saw that something was really wrong. Could barely drive to work, but was about to run into the ditch. At the request of my boss, I called the Defense Academy's contact psychologists, and then I was hospitalized. The first step was really difficult but I have received encouragement and support. I talk a lot with my ex-wife, we're really good friends. To her I will not have to explain all the things we're talking about. She knew a lot and got into the rest. My boss also rings regularly.
DKC07: Not always easy. I have often felt a great restlessness and when the first reunion was over felt an emptiness and frustration due to trivialities in domestic relationships. At some point in time after returning some calm returns to your life and you begin to find your place.
SPC08: Yes, it is difficult to readapt to normal life. You have to adapt yourself to the people surrounding you. You have to adapt to what they've done. In your absence people go on with their lives. When you come back you tend to think time has not passed, but that's not the truth.
But one also hears about the joy of returning to normal life in one's country after months of deprivations and risks. Testimonies of this kind are not numerous, but they exist and are of this tenor:
Dutch Lieut. Stellan: I noticed myself that I was very happy with all the things we have in the Netherlands. After the mission nothing would bother me. When I walked outside in the rain: no problem. When I was in a traffic jam: so what! Everything was fine. Not that I did not care anymore, but I put everything into the perspective of what I had seen and gone through in those four months.
From a quantitative standpoint a majority (40%) of the sample (again for the countries of the Soldiers Without Frontiers research) declare that they did not have problems upon returning from the missions or that they got over them in a few days, with 22% of the interviewees saying they had problems readapting. Here, too, we find a notable number of lacking responses (36%), to which the same comments made in the analysis of the operational stress data apply.
The general concept expressed by the interviewees on readaptation in the homeland is that the asymmetric warfare experience is something that changes your life, modifies your way of seeing things and the world, and leaves an indelible trace in the individual's personality. Expressions like those seen above--"it is easy to go to war, but hard to get home again" and "you come back home with a different mentality" or "you return a different person" exemplify a common condition, just as annoyance with many attitudes found in our hedonistic consumer societies is shared, annoyance expressed in feelings of "emptiness and frustration due to trivialities in domestic relationships" and "I am disgusted by people's constant interest in money and consumption. The ideals I worked for at times seem distant in our society. "
Up to here there is nothing particularly pathological, but aspects of reactivity that are hard to erase and that interfere with the serenity of the individual veteran and those who surround him are also noted. Expressions like "You have to cool down your readiness to act at any given time" and "that I still today, some 3 years after react to the sound of an sms" appear very significant in this regard. Indeed, the habits acquired living in risk situations, of always being on the alert to protect oneself and" one's comrades, are not lost quickly, and more than one returning soldier has to put time and effort into being able to relax and avoid reacting instinctively to every external stimulus.
In many, then, compared with the intensely emotional activity of life on operations, garrison life causes a sense of emptiness, of not being understood. This "feeling of emptiness" leads to self-isolation or to seeking refuge in the relationship with other veterans who, having shared the same experience, are the only ones who can understand it. "When you come back home, you feel like a stranger," says one, and another writes, "There are experiences, that you cannot share with people who didn't live them."
And finally, readaptation to one's family is often problematical: the veteran is led to think that time has stood still and that everything is like he left it, but that is not how it is. Time has passed, habits have changed, the spouse who stayed at home has unilaterally exercised the organizational and parental action, children have grown and at times, if they are very young, have trouble recognizing the returning father, who has difficulty settling back into his place in the family, with which he is unable to share his experience. And this remains one of the major problems of the veteran towards the human environment that surrounds him back home: no one can share his experience, understand his moods and the change in him. Some of the expressions reported above evidence these states of mind: "In your absence people go on with their lives." And another: "It is difficult readapting to the family environment." A third: "It is very difficult to adjust your life after mission, young children don't even recognize you as a father. When you get home, people have been living without you, so you have to be patient and get back to that routine."
The research data, drawn from the declarations of those directly concerned, reveal the existence of a problem of psychological distress resulting from deployment in asymmetric warfare situations that is in part different in the causes of the problems resulting from deployment in traditional combat and affects percentages of participating soldiers that are not high but definitely significant. In these percentages one must also consider the high rate of failures to respond (as much as 36%), a phenomenon that can be interpreted as a natural reticence of the part of the soldier to talk about his fears or problems (15).
The highest incidence appears to be constituted by problems relating to reintegration into normal social and working life upon returning from the mission. This is followed in percentage terms by anxiety situations relating to life far from the family, due in large part to a sense of powerlessness for the scant possibility of managing family situations that may have cropped up or already existed beforehand. It is significant to note, however, that these anxiety-inducing situations are created during the mission, where they combine with stress factors concerning the mission itself and intensify them. These stress factors concerning the mission appear to affect only three soldiers out of ten, but for two of the three these anxiety-producing situations are fairly controllable. The primary group confirms itself to be the individual's most important support tool for reworking and managing anxieties and fears, often in addition to the individual strategies that every soldier adopts to cope with moments of anxiety. Institutional support, the psychologist, is not refused, but his/her availability in the field still appears to be quite limited.
Overall, it is interesting to note that the soldier of the small and medium powers examined here reacts quite well, on balance, to multiple stress factors like a natural environment that is often difficult, a human environment that is treacherous and unsafe, constant exposure to threats to life and limb, the inconvenience of logistical arrangements which are often approximate, the constraint of rules of engagement aimed more at safeguarding civilian populations than the serviceman himself, the necessity of coordinating operationally with soldiers of other nations with cultural backgrounds that are often very different, media distortions (16), the linguistic differences of the context in which one operates, distance from the family, the constant sight of environmental and human degradation, widespread phenomena of deep-rooted corruption, witnessing social injustices, racism, social exclusion, and religious fanaticism in the assisted populations ... and this rather thrown-together list could probably continue for soldiers normally without any experience of combat or of missions abroad.
The fact that most are able to handle all these anxiety-inducing factors quite well is a positive datum on the whole, but the existence of these factors and their impact on some soldiers' mental stability is an aspect of missions in asymmetric warfare environments that deserves to be carefully considered.
(1) Stress is considered here an adaptation syndrome to stressors. It may be physiological but it can also have pathological aspects, including chronic ones, which fall within the field of psychosomatics. The ability to bring adaptive actions to bear implies both the possibility of actions aimed at modifying the environment as a function of the subject's needs and the possibility of undertaking a modification of subjective characteristics in order to achieve better adaptation to the surrounding environment. Hans Selye (see bibliographical references: Selye, 1956) defined as "General Adaptation Syndrome" the response the body implements when it is subjected to the prolonged effects of various types of stressors, such as physical stimuli (like fatigue), mental stimuli (work commitment), and social or environmental stimuli (obligations or demands of the social environment). On the particular topic of stress in asymmetric warfare operations, see also the chapter "Psychological Stress" by Claus Kold and Henning Sorensen in Caforio (ed.) 2013.
(2) Asymmetric warfare is defined as that form of conflict in which a structurally weaker side adopts unconventional forms of struggle in order to be able to compete with the stronger side in the confrontation (hence asymmetry). According to the classic definition by Mary Kaldor (Kaldor, 1999), these forms are used by "paramilitary groups organized around a charismatic leader, warlords who control particular areas, terrorist cells, fanatic volunteers like the Mujahadeen, organized criminal groups, ... as well as mercenaries...." The tools used are terrorism, insurgency, intimidation of populations, all the actions that political or religious fanaticism and the absence of the moral rules of civilized societies may allow.
(3) The book contains the results of a field research conducted by means of semi-structured interviews on a sample of 542 soldiers of all ranks from nine different countries that had participated in asymmetric warfare operations (see bibliographical references). The countries concerned were Bulgaria, Denmark, Italy, the Philippines, Slovenia, South Africa, South Korea, Spain and Turkey. The thematic scheme of the research is as follows: experiences of asymmetric war missions; interaction with other role actors; satisfaction and motivation; psychological stress.
(4) The book reports the written testimonies of 19 Dutch lieutenants collected by the author, Jos Groen (see bibliographical references), conducted according to a single scheme. The thematic scheme of the research is as follows: individual background; the take over; execution of the mission; the mission (looking back); considerations; most important advice; reconstruction or combat mission?
(5) The examined theatres were Afghanistan, the Arabian Sea, the Balkans, Burundi, Chad, the Comoros, Congo, Darfur, Eritrea, Ethiopia, Georgia, Iraq, Lebanon, Lesotho, Mauritania, Mozambique, Namibia, the Philippines, Somalia and Sudan.
(6) The responses given by the interviewees are distinguished by an abbreviation for the research published in Soldiers Without Frontiers and by the phrase "Dutch Lieut. + first name" for the Dutch research. The abbreviation for the Soldiers Without Frontiers research identifies the home country in its first letters, followed by the armed force--A for Air Force, B for Navy, C for Army--and the interview number. Thus the abbreviation "ITC04", for example, identifies interview No. 4 of a soldier in the Italian Army.
(7) The consequences of the impact of an IED on an armoured vehicle are described in the report of a Dutch lieutenant whose platoon went through this experience. Dutch Lieut. Marcel writes: "The General Military Nurse and Combat Life Saver started to work on the wounded. Miraculously, the gunner was not harmed at all, and the driver was lightly wounded. The other three men were a totally different story. The section commander, Lucas, had been badly wounded in the explosion. The lower body of both Marksmen had absorbed the force of the explosion. Private Dennis' lower body part looked like a child's and the upper part like that of a fully-grown man. It did not fit together at all. His legs had been completely pressed together and his thighs were more than twice their normal thickness: He had several internal and external arterial bleedings. Private Rick was still conscious, with several wounds to his legs and a big head wound. The men were wearing ear and eye protection, long sleeves and gloves. On the pallet, which had been placed on top of the floor plate, there had been fragmentation blankets. In spite of all these protective measures both men were covered in splinter wounds from the pallet, up to their eyes ... Before blowing off steam, I quickly went to the opsroom with my 2iC to hear the latest about our casualties. Rick was badly wounded, but he was going to make it. Section commander Lucas was badly wounded, but his condition was also stable. This was not the case with Dennis, who was far from stable. He was in deep coma in Kandahar hospital and both his legs had been amputated in the meantime."
(8) The field research carried out by J. D. Richardson, J. A. Naifeh and J. D. Elhai, published in the Canadian Journal of Psychiatry, 2007, Vol. 52, No. 8, is particularly interesting. The work is based on interviews with 1016 male veterans (age < 65 years) who served in the Canadian Forces from 1990 to 1999 and participated in PSOs. The authors found that rates of probable PTSD (PCL-M score > 50) among veterans were 10.92% for veterans deployed once and 14.84% for those deployed more than once. The rates of probable clinical depression (CES-D score > 16) were 30.35% for veterans deployed once and 32.62% for those deployed more than once. They found that, in multivariate analyses, probable PTSD rates and PTSD severity were associated with younger age, single marital status, and deployment frequency. PTSD is defined by the Associazione Italiana di Psicologia Cognitiva e Scuola di Psicoterapia Cognitiva (http://www. apc.it/disturbi-psicologici/disturbo-da-stress-post-traumatico) as a disturbance that is manifested as a consequence of an extreme traumatic factor in which the person experienced, witnessed or had to deal with events that involved death, threat of death, serious injuries, or a threat to the physical safety of oneself or others, such as, for example, personal aggressions, disasters, wars and combat, kidnappings, torture, accidents, and grave illnesses. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (2000), categorized PTSD as an anxiety disorder with the essential feature of direct experience of exposure to an extreme traumatic stressor followed by characteristic symptoms. This direct experience involves threat of death or injury to self or others combined with a response of intense fear or helplessness.
(9) The choice was motivated by the fact that, while an abundant literature already exists on the operations carried out by the major powers (US, UK, Russia, France), for what regards the smaller countries the literature is much more modest and field researches are almost non-existent.
(10) The expression Military Operations Other Than War (MOOTW) was widely used at the turn of the millennium (end of the twentieth century and start of the twenty-first century) to describe all interventions in peace operations that went beyond simple peacekeeping but did not yet include combat actions. See Caforio 2001 in this regard. For the adaptation of militaries to the new scenarios that have gradually presented themselves, see Maria Luisa Maniscalco (2010).
(11) The group is defined as a numerically small set of people, linked by a feeling of belonging, who interact with each other, which determines the psychological and systemic emergency. See Stouffer 1949 and Caforio 1987.
(12) As Stouffer (see Stouffer 1949) observed as well, the military must (and normally does) strive to make the smallest organic unit, in general the platoon, constitute a primary group.
(13) From the Dutch research it is not possible to draw reliable quantitative data due to its particular structure. However, the incidence of the examined testimonies suggests data not very dissimilar from those obtained for the soldiers of the other countries examined in this study.
(14) See, in the bibliographical references, Tina Pranger and others (2009), Amanda D. Chesnek (2011), and Nathalie Duclos (2012).
(15) This rate of lacking responses is unmatched by the other questions in the questionnaire, where in general it does not exceed 8%.
(16) The importance of the media-communication aspect in asymmetric warfare is emphasized by various authors: see Eco 2012, Caforio 2010.
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GEN (ret.), Vice-president of the Italian Interuniversity Centre of Historical and Military Studies, outside consultant of the governmental Italian Centre of Strategic and Military Studies, Italy
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|Publication:||Journal of Defense Resources Management|
|Date:||Oct 1, 2014|
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