All war is psychological warfare

A reader sent in an interesting account. The words below the asterisks are his...

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Regarding the US combat soldier who wantonly slaughtered sixteen Afghan civilians and who, it has since been learned, received a traumatic brain injury during a prior combat deployment in Iraq and more than likely is also suffering from PTSD, along with god-knows-what other untreated psychiatric disorders, -- it doesn't surprise me that the Army's vaunted mental health screening program pronounced this walking time-bomb fit to cope with more of the wrenching stresses encountered when redeployed to an hopelessly intractable guerilla war, in which brutal psychological warfare is the enemy's dominant weapon.

I came to appreciate just how appallingly fouled up military mental health services can be by way of a trusted friend who is a highly trained licensed clinical social worker, who used to work as a full time Air Force family counselor and therapist in the hospital at one of the gigantic Air Force bases here in Arizona. Without ever violating patient confidentiality or military security constraints, my friend would on rare occasion share with me the sketchy outlines of particularly egregious cases of Air Force malfeasance in the handling of life-damaging, or even life-threatening mental health issues.

One case in particular stands out as depressingly emblematic of Air Force style medical malfeasance: a couple of years ago, after the Holiday season was over, an important high-ranking career NCO, who previously had been diagnosed with serious anger management issues, as well as having a well established history of domestic violence, came into the base Mental Health Services office expressing guarded concern that perhaps there might be something "not right" with him. When asked by the therapist to elaborate, he proceeded to unemotionally describe how he had given his kids a puppy for Christmas, but then one morning while at home, for reasons not entirely clear to him, he became angry about something and in response, carried the puppy out to the garage, strangled it with his bare hands, tossed its body into the garbage bin and then went on about his day. Having matter of factly reported this, he then very uncharacteristically started crying.

Of course, when it comes to warning symptoms of grave and potentially homicidal psychiatric illness, one doesn't need to be a healthcare professional to realize that the wanton killing of pets is one of the most serious danger signals known and should automatically trigger immediate high-priority attention. But because this 20 year veteran NCO was only a month away from retirement, the unit commander -- a colonel who was also a medical doctor -- ordered that absolutely no mention of the incident appear in the man's chart, and directed that he be psychologically propped up and palliated for the next few weeks, long enough so that he could safely receive an unqualified discharge and thus be in fully retired civilian status. The commander made clear he was doing this, not to protect the NCO, but in order to signifcantly mitigate the enormous medical and financial burden the Air Force would otherwise have to shoulder for treatment of such a severely disturbed individual.

Such falsifying of medical records is a damn serious offense to risk commiting, especially in a case where doing so could easily wind up costing lives, much less exploding into a disastrous front-page scandal. But that just demonstrates how insanely intense the pressure is within the armed forces to resist any expansion of medical services and the attendant ballooning of costs. At the same time, because of overdeployment and staff shortages, there is ruthless pressure to extract every drop of useful potential from their personnel, to everyone's psychological detriment, especially front line troops.

I see both the troubled combat veteran who cold-bloodily murdered Afghani civilians and the ominous psychopathology of the NCO which the Air Force swept under the rug as being intimately related. In both cases the military healthcare system managed to blind itself to glaringly obvious symptoms that are well-established predictors of violent behavior. Symptoms I might add that any bright cub scout with a Red Cross merit badge could spot. It also blinded itself to its moral obligations to the sick and suffering. Instead of providing intensive hospitalized therapeutic assistance for both men, the system simply redefined medical reality and in effect decreed healing had occurred. And with that, these two highly unstable bundles of human TNT were quietly turned loose on an unsuspecting world. I can't tell you for sure what the NCO's retirement looks like today because I understand he moved his family out of the country the minute he was discharged.

But we sure as hell know what happened with the other guy.

Typically, in cases like these, the standard cliché goes, "The system failed him." I would maintain that actually no failures occurred. What happened was exactly the kind of horrible trade off in human misery inherent in sub rosa policies generated by Pentagon leaders, who are obsessed with denying the true modern-day psychiatric costs of waging modern-day wars.