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  • Richard F. Mollica, MD, is the author of "Healing Invisible Wounds: Paths to Hope and Recovery in a Violent World." A Harvard Medical School professor of psychiatry and director of the Harvard Program in Refugee Trauma, Dr. Mollica holds an MAR from Yale Divinity School and is a Fulbright New Century Scholar. He is the recipient of many honors and awards, including the American Psychiatric Association's Human Rights Award.

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Posts from January 2008

January 25, 2008

America's Domestic Violence to Our Soldiers Returning Home from Iraq and Afghanistan

The story in the New York Times on January 13, 2008 (entitled: "Across America, Deadly Echoes of Foreign Battles"; click here to access the article) saddened me.  These stories reflect as much upon our social relationship to our veterans as to the psychology underlying the violent actions of combat veterans.  Domestic violence results in violent acts by perpetrators of violence.  Of course, this is not always true since some individuals have the capacity for hurting others regardless of their environmental context.  In the case of the soldiers in the New York Times story, none had had a previous criminal or psychiatric history prior to their current actions.

"Domestic" in the Oxford English dictionary refers not only to "one's place of residence or family affairs" but also to "one's country or nation". Certainly both elements of the term are applicable to our country's returning soldiers.  Now let us investigate the basic question, "How can the transformation of young men and women (as well as some adolescents) into trained killing machines be reversed once they return to a normal society not at war?"

Soldiers are trained to kill and are legally allowed to break standard conventional norms in order to resist an "enemy" of this country.  The taking away of someone else's life which in many religious circles is considered precious, unique and sacred, is at minimum an instrumental act to achieve a socially condoned outcome. Yet the killing and death of an enemy as well as the enemy's killing of a fellow comrade in arms has to be one of the most disturbing of all human activities.  Literally, within the brains of many soldiers these legally sanctioned violent activities are stored as memories that cannot be forgotten.  While few soldiers returning home commit violent crimes, in all of the stories presented in the New York Times article you are able to see a glimpse of a soldier's shattered life world ( i.e.. all of his/her life experiences to date).

These soldiers can be seen to be tumbling down from a relatively normal pre-war life to a new post-war experience of emotional distress and ruin.  In my clinical work over the past 30 years, I have witnessed many victims and perpetrators of extreme violence living in a life of despair that is full of nightmares and traumatic memories.  I have treated family members who cannot seem to be able to comfort their soldiers with their love and support.

It is an ancient and well-known story that society rejects their wounded warriors.  Sophocles in his great play Philoctetes more than 2000 years ago described the plight of the Greek hero, Philoctetes.  Philoctetes, who is mortally wounded by a vengeful act of the goddess Hera, is abandoned by the Greeks on their way to Troy with a snake wound of unbearable and extraordinary pain.  He is left to suffer alone on the island of Lemnos with a wound so sever he howls in agony and a stench so foul it permeates the clean air of the island where he is a prisoner.  This play provides a classic metaphor of society's treatment of its wounded warriors.

It is my belief that American society (like many societies) cannot accept its guilt over the soldiers' injury.  At the same time, society is ashamed of the soldiers' weakness, especially if they exhibit emotional problems from the war.  But most importantly, citizens are afraid that the soldiers' rage and deadly killing skills will be turned against them.

The soldiers in the New York Times' article fulfill our worst fantasies of the "crazy" homicidal combat veteran.  These combat soldiers broke free somehow of their socially prescribed roles to "suck it up", put the war behind them and/or passively accept a psychiatric diagnosis of PTSD and enter into a lifetime of treatment at the Veteran's Administration hospitals or even worse suffer a homeless existence of begging for handouts in our cities and towns.

Yet maybe there is a middle ground for our warriors who have returned home. Philoctetes was healed not only by the gods but by the love of his great friend Achilles' son Neoptolemus.  The systematic elimination of empathy in a soldier contributes to a soldier becoming an effective "killing machine" in the war.  Similarly, the military must reverse this process by re-kindling the capacity for empathy in those returning home.  The re-entry of soldiers into their families and communities must be given immediate attention and responsibly resourced.  The havoc being perpetrated on soldiers' families is not an unpleasant side-show but a direct cost of war that must also be ameliorated.

It would be great if any soldiers or their family members, the American Legion, or other veterans could contribute to this discussion.  I would be delighted to post anyone's comments and/or relevant links on this blog.

January 11, 2008

THE WAR ON TERRORISM IS A WAR ON DOMESTIC VIOLENCE

I would like to thank Angela and Megan for their thoughtful comments.  Certainly the empathic failure demonstrated by all acts of domestic violence have enormous social and political consequences. It is hard to imagine sensitivity to a neighbor or community member if one is unable to respond empathically to our own family members. I remember the recent case of a female drug addict who allowed many men to have sex with her 12 year old daughter to obtain money.  There are so many things wrong with this situation one does not even know where to begin. The fear, anxiety, and degradation of the young person when imagined is almost too much to bear. This type of humiliation leads to anger/revenge and/or hopelessness and despair, with sometimes both states existing concurrently in the same person.  As Angela suggests this is our most common form of terrorism that we must do battle against.

Any suggestions on how to prevent all forms of interpersonal terrorism ?

Thank you
Richard

January 07, 2008

THE PUBLIC HEALTH CAMPAIGN TO INCREASE FAMILY EMPATHY IN THE BATTLE AGAINST VIOLENCE

I would like to thank everyone for their comments over the past two weeks. Forming a new anti-violence structure of government is certainly an interesting idea I had never considered. In Italy recently, people were so sick of the corruption in their government, an email was sent prompting millions of people to congregate, protesting that they had had enough. So many citizens today feel this way about the violent world we live in and the increasing violence in daily life. Many other comments on the blog centered round the age old question of whether we need to fix the violence in ourselves first before we take aim at stopping the violence of perpetrators. Since I am not a great philosopher I cannot give an answer to this question. Clearly human beings are very aggressive and can hurt others given the right social cues (e.g. Milgram experiment). But in my work and dialog with citizens around the world in post-conflict societies it has come to my attention that in many violent situations there is a breakdown in empathy especially in the home. I would like to share a story that still disturbs me after hearing it 2 years ago in Peru. A clinician told me of the big problem of domestic violence fueled by political violence in Peru. The WHO study found Peru to have one of the highest country rates of domestic violence. This clinician said that she had helped a patient from a small Andes village that was repeatedly beaten by her spouse. She was able to work with the husband and wife to reduce this situation. The clinician felt very good about her success. The patient then went on a little trip to see her family in another village. I do not know where her husband was when the following events unfolded. She came home and found her teenage son hanging from a tree outside the kitchen window. Her brother—the boy's uncle—had killed the boy over a minor land dispute with this family. The uncle was arrested for three days and then was released by the major, who was a friend of the uncle. That was the end of his prosecution. The woman came back to therapy and the clinician was told she would be harmed if she tried to interfere in this case. The clinician was devastated.  And so she shared with me this story. I was also overwhelmed by such a cruel act by the boy's uncle. This is a story of a total breakdown in empathy. You can imagine that if you have family violence with little to be empathic to your immediate family members, how can you have any regard at all for your neighbors or for people who are different from yourself. The battle against violence must work first to increase empathic relationships in the home.

Looking forward to your comments on this aspect of the declaration.  Also, I will eliminate as suggested the term "poor" as in "poor women".