How to give someone a howling case of PTSD: The Army’s recipe in action

BY THOMAS E. RICKS

JANUARY 30, 2015

Much talk of post-traumatic stress disorder has come out of the Iraq War, but little is as striking as that of Lt. Col. Bill Russell Edmonds, a Special Forces officer whose memoir is scheduled to appear in a few months.

In the book, titled God Is Not Here: A Soldier’s Struggle with Torture, Trauma, and the Moral Injuries of War, Edmonds says in his first sentences, “I’m a good person forced to make many horrible choices.”

What especially makes it stand out is that it amounts to a textbook on how to develop a howling case of post-traumatic stress disorder (PTSD). All the ingredients identified by the noted psychiatrist and veterans’ counselor Jonathan Shay in his two groundbreaking books on the syndrome are here.

If the Army in some perverse experiment had consciously wanted to try to induce PTSD in one of its officers, it could not have done a more effective job than it did on Edmonds.

Much talk of post-traumatic stress disorder has come out of the Iraq War, but little is as striking as that of Lt. Col. Bill Russell Edmonds, a Special Forces officer whose memoir is scheduled to appear later this year.

In the book, titled God Is Not Here: A Soldier’s Struggle with Torture, Trauma, and the Moral Injuries of War, Edmonds says in his first sentences, “I’m a good person forced to make many horrible choices.”

What especially makes it stand out is that it amounts to a textbook on how to develop a howling case of post-traumatic stress disorder (PTSD). All the ingredients identified by the noted psychiatrist and veterans’ counselor Jonathan Shay in his two groundbreaking books on the syndrome are here. If the Army in some perverse experiment had consciously wanted to try to induce PTSD in one of its officers, it could not have done a more effective job than it did on Edmonds.

To begin, put someone in a situation in which there appear to be no moral courses of action. Edmonds’ description of being in this kind of situation is a powerful narrative device, for he is bidding the reader to follow him on a descent into hell. Those who take the dare will quickly find out what some of those evil choices were: “I lived according to Iraqi rules, and I interrogated with only one rule—do what was necessary.”

Soon, we see him wearing a black mask and sitting in a dank, cinder-block basement prison cell in Mosul, Iraq. “There is no better place to learn about God than from killers who use God to justify their killing,” he writes in one particularly striking sentence. It was mid-2005, a particularly bad time in the Iraq War, when American leaders, both political and military, were still deeply in denial about how badly the war was going. Indeed, as Edmonds observes, much of the massive American military effort in Iraq at the time was counterproductive, simply antagonizing Iraqis.

The next step in the recipe is to take away all sense of control over one’s life. Edmonds did not command a unit in Iraq. Rather, he was an advisor to an Iraqi intelligence officer, trying to help by asking questions and giving advice. He felt his moral fate was not in his own hands. Indeed, not even his worldly possessions were under his control, because he had given financial power of attorney to his girlfriend, who lived in his apartment but with whom he broke up midway through his deployment.

Next, place him in a situation for which he is unsupported and untrained. For example, Edmonds seemed at first to believe that torture works, something that most seasoned interrogators I know reject. On top of that, his commander was a distant figure, seemingly paralyzed. Lack of competent, caring leadership is a powerful driver in developing PTSD.

It gets worse. Shay has found that one of the most important palliatives for moral trauma is good cohesion among troops. Unfortunately, Edmonds shipped overseas with a small ad hoc assemblage of soldiers whom he barely knew. Less than 100 days into his yearlong deployment, he observed, “I am getting frustrated with the Americans I work with, and I just do not want to be around them anymore. … [W]e just all start to go our own separate ways.” He was isolated and vulnerable.

Then, as he said at the outset, he felt he had to decide between bad and worse choices. “I balance between my professional obligation as an American soldier to capture or kill the terrorist and my professional obligation to protect the terrorist that we capture,” he confessed to himself halfway through his tour of duty. “I’m [screwed] no matter what.”

Finally, to really make sure the PTSD takes hold, keep the patient’s brain on boil with daily jolts of adrenaline. “Knowing that death is so close makes me feel intensely, and intensely living is absolutely addictive,” he wrote.

Soon, naturally enough, the disease was deep inside him. “I just don’t seem to care anymore, and it’s scary to think about how un-scared I have become,” he wrote as his tour wore on. By this point, he had lost his faith in humanity: “Looking at ourselves, I know the bad outweighs the good.”

In The Evil Hours: A Biography of Post-Traumatic Stress Disorder, David Morris, a former Marine officer, writes that “PTSD is a disease of time.” I think that observation is accurate and is reflected in small ways throughout Edmonds’ memoir. We see it at first at about this point in the book, when he is succumbing. “Time just ticks and ticks, and every time I check it seems that no time has passed.” This is a symptom, I think, of becoming untethered. I think more research should be done on this crucial aspect of PTSD.

As Edmonds writes, looking out at the sewage-laden Tigris River flowing past his base, “Time is like a thick fog that hangs over the river. Living here is like taking a never-ending walk in this foggy soup—time seems to slow and the clarity of events blur.” Other factors can be mixed in. The pot can be stirred with a sense that, as Edmonds puts it, “we’re losing this war.” That can only make all the suffering and sacrifice seem more inexplicable, and so more toxic.

Finally, add one more lethal ingredient: a sense of betrayal. When Edmonds decided to report an instance of torture of prisoners, he was at first ignored, and then he saw the same people who first ignored him conduct an investigation that cleared everyone. “Do we only care about right and wrong when it becomes a media story?” he asked himself. In the book, he doesn’t answer that question.

By the end of his tour, he was brimming over with self-loathing. “I hate myself for giving up,” he concluded. Home beckoned to him, seeming to promise relief, but he found that when he got back home, he was just as stuck. He could not “stop this continual slide into a past that won’t say good-bye.” Here there are two final kicks: Edmonds was macho enough to refuse for years to seek help, trying to tough it out on his own. Then, when he did belatedly cry out in pain, the Army responded with suspicion and irritation.

This is not a story with a Hollywood ending. Instead, it concludes in a human way, with Edmonds finding a way—he hopes—to live with himself in purgatory. I wish him well.

Reading this book, I felt anger and frustration with our military leaders. They effectively set up Edmonds for his fall. All the ingredients discussed above were well-known to experts on the day Edmonds flew into Iraq. His leaders failed him. They did not take care of one of their own—not in the way they prepared him for his mission, supported him there or took care of him when he came home. More than anything else, this book is an indictment of them. The next time I hear a general say he loves his soldiers, I will ask him if he has read Bill Edmonds’ book.

Thomas E. Ricks is author of five books about the U.S. military, including two about the Iraq War—Fiasco: The American Military Adventure in Iraq and The Gamble: General Petraeus and the American Military Adventure in Iraq. He writes the “Best Defense” blog for ForeignPolicy.com and is national security advisor at New America, a Washington, D.C.-based think tank.