The “Dark Beast” Behind Combat Trauma—a Clinician’s View

This particular article is inspired by my perusal of Lt. Col. Dave Grossman’s “On Killing: The Psychological Cost of Learning to Kill in War and Society” and “Shooting Ghosts” by Thomas J. Brennan and Finbarr O’Reilly. I am a retired clinical psychologist and psychology professor. I also served as an Air Force medic during the Vietnam Conflict. I did not serve “in country”. I served as a medic at Andrews AFB in the emergency room of Malcolm Grow Medical Center. There I witnessed considerable physical trauma. I witnessed death on a number of occasions, some violent, some peaceful. I remember the violent ones.

I also served temporary duty (TDY) at Lackland AFB working with airman stationed in Vietnam, presenting with PTSD and substance abuse disorder (SUD).  As a clinician in Behavioral Health Care, I dealt with folks presenting with multiple psychosocial trauma, including combat Vets from Vietnam.

I’ve not witnessed directly the ghosts of combat. Those who have repeatedly are haunted by those of comrades killed (KIA) and by those who they killed, especially those who are civilians. Thus, they experience what I refer to as “compacted grief”. During war, there is little room and energy to grieve.

I completely agree with Lt. Col. Grossman that most of us possess a natural inclination to not kill other humans. No amount of combat training can prepare soldiers for the realities of war and combat. I see war as an extreme expression of insanity, even when war is deemed by some to be necessary and the participants are “voluntary”. War and combat sear us at the limbic level, a necessary encounter which I refer to as “Dark Beast”. The Vets I have treated and my many clients in BHC have taught me so much about this Beast. The following account here centers on my running commentary as I read “Shooting Ghosts”, using my observing clinical ego.

When I embarked on reading their candid descriptions of encountering repeated episodes of violent death, At times I felt guilty for not having served in Vietnam. I joined the Air Force after my college deferment lapsed once I graduated. I did not really support our endeavor there. I never felt this Conflict to be an urgent and immediate threat to our nation’s integrity. I became a medic so that I would not have to kill anyone, nor would anyone would be killing me. I did therapy with some of the field medics who were confronted with killing. Killing is counterintuitive to our ethical oath to: above all else, do no harm.

From Chapter One, I disagree that “Misfits Go to War”. We join the military for a number of reasons. For the most part, the Armed Forces want servicemen with integrity who join for a higher purpose like serving our country and protecting others. The bonds forged with comrades begin during advanced training and intensifies early in deployment. Individual survival is directly associated within this group that we refer to as our squad. It is this commitment that soldiers go into battle and come back as a group which I refer to as “affiliative aggression”. Soldiers are protecting one another!

The second disagreement is that war and journalism do mix in order to inform the rest of us about the horrors and terrors of war, and the tremendous cost borne by those who directly experience it. And none of us are “fearless and invincible”. In fact, my professional experiences assure me that life is quite precious and tenuous at the same time; so we dearly need to hold onto it! And guns and cameras are valuable tools of the respective trades.

Chapter Three: Ambushed

Now it is kill or be killed by the enemy. Affiliative and defensive aggression is rising. They sustain some injuries and every squad member returns to their outpost. No time for “mental casualties”; the BB is really present for the first time! An RPG creates a concussion suffered by the squad leader.  Back at the outpost “Air Force medics” come to the rescue. Everyone is alive, but are they really? Concussions are quite serious. Each skirmish does not change the outcome of the war; yet indeed changes those who participate!

Chapter Four: Walking Wounded

The human brain consists of about One Trillion nerve cells, and about ½ of our genome is dedicated to the form and function of this organ. Sounds like a lot and many that can be spared. Indeed, the brain is well known for its neuroplasticity! I’m uncertain as well if God has or has not allowed us to contemplate going to war let alone engage in it. Traumatic Brain Injury (TBI) also occurred in Vietnam, not just in our more recent conflicts. Perhaps it is garnering more clinical attention? We know that it is also intimately related to Clinical Depression and PTSD. I agree that repeated combat encounters result in a “kinship and loyalty” that many of us will never know!

Chapter Five: The in-between

The brain and all of our human senses process all of our internal and external experiences. I refer to the brain as a “master accountant”. Much of what we process occurs beneath our conscious awareness.

In fact, there are at least seven streams of awareness. Some are deeply embedded suggesting that we better remember certain experiences more than others to ensure our survival.

Those in combat continue to experience the traumas once confronted repeatedly by the DB! Being back “home” and away from the front lines does not matter. We are genetically primed by our “threat alarm” in responding to perceived and/or real threats by fighting, fleeing, or freezing. Our primary cognitive processes regarding threats pertain to harm, loss, and challenge. We must not ignore them!

Even photographers and journalists are not immune to being harmed or killed! Immunity from stress and trauma is indeed an “illusion”. During adolescence, males exhibit an increase of invincibility (probably due to the significant infusion of testosterone). And there is no “magical cure” for real trauma. And life is more important than what each of us do for a living.


Chapter Six: Human Triggers

Another death of a platoon member, who is very experienced in combat; and he is survived by a wife and children, gets a lot of attention. His loss impacts more than this soldiers. And indeed death is all around as the “Dark Beast” possesses an insatiable appetite for “kills and body counts”.

The effects of TBI on the squad leader are apparent. And there is no room for complacency and lapses of concentration! They are becoming human targets and increasingly aware of this reality. The sights, smells, and sounds of violent death are deeply etched in the collective minds of these soldiers. Home for them seems a long way off! The platoon leader earns a Purple Heart. And he feels he doesn’t deserve it. So far, he and his men are alive.

Chapter Seven: Lost Limbs and Skull Tattoos

Another photographer is severely injured having stepped on an IED. It is natural to “dread” the “damaged cargo” carried by the MEDEVAC choppers. Some photojournalists become resigned to this possible occupational fate. There is a growing sense that these soldiers may not ever win the “hearts and minds” of the Afghan civilians despite their best efforts to do so.

Some of the violence and deaths of comrades that these soldiers experience are etched on the largest sense organ—the skin. No time to deal with any of this in a combat zone, no time to grieve! Suppression of trauma from previous combat excursions does not work either! And the photojournalist embedded with this squad begins to question his witness position and “feels predatory, repulsive, and a betrayal of human decency”.

Chapter Fourteen: Coming Undone

The home front is becoming undone. Interpersonal relationships are becoming frazzled. The natural regression after repeated exposure to the “Dark Beast” is taking its toll. All the prescribed psychotropics (chemical cocktails) in the world won’t make that much difference. BTW suicide among combat vets is rising despite priority efforts to prevent them.

Chapter Sixteen: Echoes of Iraq

The Boston Marathon bombing reawakens images of the “DB” on US soil for the second time since the attack on 9-11. Surely there is no safety and security now! Understandably, cemeteries and headstones serve as triggers. For soldiers converting back to civilian life, there exists a natural disconnect between military culture and the civilian role; clinicians refer to this as cognitive dissonance, and it penetrates much deeper than just our thinking!

Advanced combat training does not really train soldiers to kill the designated enemy, only the illusion of them. And the military certainly does not prepare them to kill civilians such as children, women, and the aged. Yet, this happens in actual combat. For example, during the Vietnam Conflict, it is estimated that more civilians were killed than enemy combatants on both sides. This distinction gets lost in the insanity of combat. Yet the civilian-soldier has to come to terms with this reality; and based on having conducted psychotherapy with Vietnam combat Vets, the grief and regret become almost unbearable! I refer to this state as psychosocial death. Sociologist, Erving Goffman, refers to this as “mortification”. Killing the innocent does not reflect affiliative or defensive aggression. To me, it is an adverse consequence of encounters with the “Dark Beast”.

Final Thoughts and Observations

First of all, I express my sincere gratitude to all those who have, do now, and will serve in the Armed Forces; and my gratitude to all the loved ones who endure this journey with them. I want you all to know, that in my clinical view, soldiers do what they do out of affiliative and defensive aggression; they are not predators!

Those who send humans to war need to examine much more closely the human damage done to the participants and family members for whatever gains are earned in doing so.

And it is my clinical observation that group counseling/therapy could be more efficacious in treating those who are haunted by the ghosts of combat. Group therapy can recapitulate the crucial military unit- the squad. This offers a better opportunity for some healing from the repeated exposure to the “Dark Beast”.

Richard G Kensinger, MSW

Image via DasWortgewand/Pixabay.

Richard Kensinger, MSW

Richard Kensinger, MSW, has over forty years of clinical experience in behavioral healthcare as a psychotherapist, trainer, consultant, and faculty member in the Psychology Department, Mount Aloysius College. He has also taught at Penn State, University of Pittsburgh, and Temple University. He is also a lover of "football", known in the USA as soccer. He is currently associated for over 30 years with youth "football", 26 as a referee.
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