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Conflicting Notions on Violence and PTSD in the Military: Institutional and Personal Narratives of Combat-Related Illness

Culture, Medicine, and Psychiatry volume 40, pages 338–360 (2016)Cite this article

Abstract

Research indicates that soldiers struggling with PTSD under-utilize mental health care. Quantitative studies of barriers to care point to the importance of soldiers’ beliefs about mental health and mental health interventions in their care-seeking behavior, yet these studies still struggle to understand the particular beliefs involved and the ways they impact care-seeking behavior. This preliminary study makes a start in examining these questions through qualitative literature analysis. It maps out dominant messages surrounding PTSD in military mental health interventions, and explores how they can both shape and conflict with soldiers’ personal notions. It does so by analyzing these messages and notions as institutional and personal (illness) narratives. Institutional military PTSD-narratives, which draw on mainstream scientific and clinical models, appear to communicate contradictory notions on the meanings of violence and its psychological consequences, often without acknowledging these contradictions. As such, these narratives seem to shape struggles of soldiers, both within themselves and with the military institution. The identified conflicts indicate, contrary to the individualizing and decontextualizing focus of dominant PTSD-understandings, that soldiers’ struggles also have social and moral dimensions. This has important implications for both research into PTSD-interventions and understandings of PTSD as such.

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Notes

  1. See also e.g., http://www.ptsd.va.gov/apps/AboutFace/questions--what-ptsd-is.html [A website of the US Veteran Affairs National Center for Posttraumatic Stress Disorder]; http://www.pdhealth.mil/wot/fact_sheet2.asp [A website of the US DoD Deployment Health Clinical Center]. (Accessed at 08-04-2015).

  2. To be sure, cognitive behavioral therapies do not simply aim to restore pre-deployment cognitive schemes. They may aim to help altering cognitive schemes. But the premise of, for instance, exposure therapy is still that soldiers’ thoughts and behaviors are changeable interpretations of the world rather than ‘knowledge.’

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Authors and Affiliations

  1. Section of Military Management Studies, Faculty of Military Sciences, Netherlands Defence Academy, Breda, The Netherlands

    Tine Molendijk, Eric-Hans Kramer & Désirée Verweij

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  1. Tine Molendijk
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  2. Eric-Hans Kramer
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  3. Désirée Verweij
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Correspondence to Tine Molendijk.

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Tine Molendijk declares that she has no conflict of interest. Eric-Hans Kramer declares that he has no conflict of interest. Désirée Verweij declares that she has no conflict of interest.

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Molendijk, T., Kramer, EH. & Verweij, D. Conflicting Notions on Violence and PTSD in the Military: Institutional and Personal Narratives of Combat-Related Illness. Cult Med Psychiatry 40, 338–360 (2016). https://doi.org/10.1007/s11013-015-9469-0

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Keywords

  • PTSD
  • Military
  • Barriers to care
  • Illness narratives
  • Military culture