Bad War, Bad Science, Bad Reporting: Take Your Pick

Lt. Col. Robert L. Bateman is an infantryman, historian and prolific writer. Bateman was a military fellow at the Center for Strategic and International Studies (CSIS) and has taught military history at the U.S. Military Academy. He is stationed in Washington, D.C.

The opinions he expresses in his columns are his own and do not reflect those of the U.S. government or the armed forces.

War is bad. We can agree on this.

As both a practitioner and historian of war, I feel no compunctions about saying that and no reason to pretend otherwise. Some wars are Just, and some may be Unjust. Some wars may even be necessary, but they are all bad. The idea of a Good War is a myth. It is base propaganda, and nothing more. War should be the absolute last resort. 

As a soldier, however, it is not my job to make political decisions about whether we should or should not go into, or exit, a particular war, and that decision is political. Optimally, at some point, the civilian leadership of this democracy would hopefully consult with experienced military personnel about the likely results of this or that military option, but that advice is to be given privately. In public, we soldiers must remain absolutely neutral and follow the direction of the elected civilian leadership. We must, while we wear the uniform, remain outside of politics.

Your role is similar, if somewhat inverted. You must challenge everyone and everything. You cannot accept anything as a “given” short of elements of physics such as, oh, say gravity. Yes, I am pretty sure you could take that for granted. But just about everything else you must question and check, regardless of who says it because, like us, you are supposed to be neutral.

You have a slightly trickier problem to deal with, though, because some topics, by their very nature, are inherently political. Writing about them, therefore, requires careful phrasing and even more careful editing. I have great respect for reporters who deal with the minefield of day-to-day politics. Theirs is a tough row to hoe, and they generally do it well, taking extreme care in their words and working very hard to be balanced and skeptical.

It is in other areas where journalists sometimes slip, areas that they might not understand are, in reality, deeply political issues. Science writers dealing with global climate change have now become aware of this fact, as have those dealing with issues like evolution and religion, but there are other areas as well that are just as loaded. Unfortunately, sometimes this goes missing because it might not be apparent to a general-interest reporter how political a topic is for your readers.

Post-Traumatic Stress Disorder (PTSD) is one of those topics, as is the topic of suicides by servicemen due to this syndrome. A brief examination of the history of this diagnosis may help you understand why, beyond the obvious, this can be a political issue.

The history of psychiatry is deeply interwoven with politics, though not a lot of people recognize this fact. This is somewhat natural in a field that teeters constantly on the ledge between “hard science” and “soft science,” but in psychiatry it can reach extremes. In the history of psychiatry dealing with combat stress, this is especially so. There are, believe it or not, “hawk” psychiatrists and “dove” psychiatrists, and their battlefield is the realm of definitions of diagnoses.

The central reference work within the field is the Diagnostics and Statistical Manual, which came out in 1952. It is now in the fourth edition, and so is commonly called DSM IV. This massive tome represents what is “known” by the field, and it is a collective and collaborative product that changes over time. In the mid-1970s, it was going through such a revision, resulting in DSM III. That was the moment when what we now call PTSD entered the lexicon. But the term had an earlier, political, origin.

In 1970, two New York City-based analysts, who also happened to be major players in the anti-war movement, began to work with the Vietnam Veterans Against the War group. Not long afterward, in 1971, the two men, Robert Lifton and Chiam Shatan, proposed a new diagnosis. They called it “Post-Vietnam Syndrome,” directly linking the diagnosis to a specific war, and they did so deliberately. Lifton, in fact, was quoted as early as the spring of 1969 contending that the Vietnam War “may intensify the violence in his collective behavior,” referring to Vietnam veterans he has not yet even met. “It creates a jingonistic attitude. It’s not an organized jingoism they respond to but a hatred of all Vietnamese because of particular things that may have happened to them in Vietnam.” You’ll find that quote in a story written by Richard Holman for the Washington Post on May 3, 1969, headlined “Guilt Feelings Seen for Returning GIs.”

Politics caused a compromise in the term, although it was used throughout the 1970s, so that in the next edition of the manual, DSM III, “Post Traumatic Stress Disorder” first appeared. According to B.G. Burkett and Glenna Whitley in their book Stolen Valor, as many as 2 million of the 3.3 million men who served in Vietnam suffered from the affliction. Rather high, one might think, when one realizes that only about 330,000 to 400,000 saw actual combat while in Vietnam, depending upon how you describe “combat.” And that, too, resulted in some really bad and, frankly, embarrassing reporting by several major outlets.

Which brings us to the present. In one story, penned last month in Government Executive (a fairly influential inside-the-beltway publication), the lede [1] was this: “… news broke last week that nearly 1,000 troops a month have attempted suicide after returning from service in Iraq and Afghanistan, according to internal VA e-mails, even though the department publicly acknowledged only 790 suicide attempts in all of 2007.”

Unfortunately, that’s not quite true. There may be 1,000 veterans a month who have made the attempt, but that number is the total, out of all 25 million veterans tracked by the Veterans Administration, not out of the 500,000 recent veterans. There is, you might observe, a difference between 25 million and half a million. The same publication ran a story [2] last week that was slightly more accurate, at least at first glance:

“Suicides by veterans of wars in Iraq and Afghanistan could well top the combat deaths in the two conflicts, according to the top official of National Institute of Mental Health. On Monday, Dr. Thomas Insel, director of the National Institute of Mental Health, told reporters at an annual meeting of the American Psychiatric Association in Washington that it was possible that ‘suicides and psychiatric mortality ... could trump combat deaths.’”

But what does not come out in this story is the skepticism that journalists are supposed to exhibit. Dr. Insel, a man who is, I am sure, dedicated and intelligent, as head of NIMH once sponsored a study [3] that said 50% of all Americans will suffer from mental disorders .   What was not noted in the recent commentary by Dr. Insel were the counterpoints made against the results of that study. Comments such as:  “On the other side are psychiatrists who say they believe that the estimates are inflated. ‘Fifty percent of Americans mentally impaired - are you kidding me?’ said Dr. Paul McHugh, a professor of psychiatry at Johns Hopkins University.

“While the new survey was carefully done, Dr. McHugh said, ‘the problem is that the diagnostic manual we are using in psychiatry is like a field guide and it just keeps expanding and expanding.’

“‘Pretty soon,’ he said, ‘we’ll have a syndrome for short, fat Irish guys with a Boston accent, and I’ll be mentally ill.’”

Now the fact is that war has been messing up people’s minds since Thag first smashed Glog on the head with a rock. In the American Civil War, the symptoms we now know as elements of PTSD were lumped together and called “nostalgia.” In the first world war, it was “shell shock,” and in the second world war and Korea, it was called “combat exhaustion.” All of these terms were loaded with politics as well. But when Lifton and Shatan deployed their diagnosis, it was with a specific, anti-war, political intent.

Because few people outside of the field know about these origins, or the arguments within the field of psychiatry, it appears that many reporters are willing to accept the assertions of those with M.D.s and Ph.D.s at face value, purely on the apparent thesis that “Well, they’re scientists, this is science, it’s not political.” But my lord, would you give any other field such a pass? No, and you should not.

War affects those of us who have experienced it; there is no doubt about that. Upon my own return from a year in Iraq, I found my startle response exaggerated for certain noises (benign here, not so much over there), and it took about a month before I was comfortable driving in traffic. But for me these symptoms of PTSD faded moderately quickly. Others are not so lucky and suffer effects that last months, or years, or forever. PTSD does exist, and it can exacerbate the normal day-to-day stressors one feels in civilian life. And there have been good, skeptical, informational articles written on the topic, to be sure. But one should really examine the sources, no matter if they are generals, or doctors, or lieutenant colonels for that matter.

We need that from you.

The author owns no stock in any media company, holds no appointments to any boards and is generally entirely beholden to the U.S. government for his monthly wages. You can write to him at R_Bateman_LTC@hotmail.com [4]